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(gT PERMIT APPLICATIC4 <br /> BUILDING/ MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> — <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2602 Went PROPERTY TAX#: d0 437 J/,/. ,...762,166 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: /7Z-/.0i146 ,F12,027,042_1cls&ZOC1 NANT NAME(If Commercial): / Vi /--I�/U <br /> OWNER MAILING ADDRESS: STREET 2.0 Z du1G,54AI ' / ....-r !t)0,¢- <br /> CIN gikir STATE 441, ZIP q 0,65 <br /> OWNER PHONE L2S —7A3— %, le, OWNER EMAIL ' <br /> CONTRACTOR NAME: /"l /V 06)/0 J' G <br /> CONTRACTOR ADDRESS: STREET 4701___W C L� , ) L( VE.- <br /> CITY WIC. "/-_ STATE W Pr- ZIP Gi3 <br /> CONTRACTOR PHONE: +25 3 ' 3+3-qogc CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): fl 41,15c.-- ci LS4 D g CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) psi <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR MOTHER(Please Specify) ,1v ,AW r ,< '`i G/Z� <br /> CONTACTTNAME:y-� {�� 71 ��//piz CONTACT PHONE: ,_ 20`2.-711 [ C� y / <br /> 772-VW fl / /CLI.!—J/�l'7'_!/%e l- I 7S CONTACT EMAIL: 771..\A„.V ie...p post thAv x/-'( C�-y yaw. czno1 <br /> BUILDING PERMIT APPLICATION c �_ <br /> Existing Use of Building: 7i&)/ Poll,. Contract Price of Work:$ Zd©l G'dt--'1,HO+�. <br /> Proposed Use of Building: I(E- (1 ' Heat Source: peas DElectric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: Commercial ❑Industrial <br /> Type of Project El New DAddition ❑Remodel ❑Repair 14'.I. El Sign ❑Sprinkler El Demolition CI Change of Use <br /> DESCRIPTION OF WORK: �� <br /> EC ►nA C d <br /> S 4 a).01 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): Aft() y \-b . 1 01 t qv urs. 1,c ithikal `,,'t.el d'060s <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_ Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> _NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> _Forced Air Systems Unit Heater Bathtub Urinal <br /> _Gas Piping _ Boiler — Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> _Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> _Gas Range Ducting Dishwasher Roof Drains <br /> _Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> _Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT.'I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Buildin, fficial before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I o p with the tate Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT � G�-y� �^ <br /> 9/1//0611 Q 2IO el u horized Agent SI (Revised 5/W2016) <br /> C_If . <br />