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May 07 2019 06:32AM Washington Wat>—eaters 8663757454 pagl <br /> PERMIT APPLICATION <br /> BUILDING I MECHANICAL I PLUMBING 1 SIGN /SPRINKLER! DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (r.)42C-0.:7 0010 I FAM las 267.5567 I(F)P,rprRITPPROeveretiwa.aov I www,everettwa.govipermits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION� �� <br /> PROJECT SITE ADDRESS:11 a na,St Lai 98240 #: CCCM___iii i LpROPERTY TAX <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • <br /> J h O �t a S,�a CONTACT INFORMATION <br /> OWNER NAME? V + TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET Cila_422124 Et zIP�BC7'rc1� <br /> r� �ry crry 61tre STATE W <br /> OWNER PHONE:1195- �xg tom'T!� '` I TOWNER EMAiL: _ <br /> CONTRACTOR NAME: 1'f 1�v'�& IA) �Te/! U� Q� � r�n <br /> CONTRACTOR ADDRESS: STREET 11(5j Z I t IoVII" A�'V't 5e ! JJ qGam' uim ,' <br /> cir R fn. ✓1 STATE II.G ig" z q r,U 5�' <br /> CONTRACTOR PHONE: 46 483"- qg7! p 'CONTRACTOR EMAIL: t,(,J f}- Ail <br /> WM-1 `'"' ' l La am <br /> CONTRACTOR LICLNCE#(fCQUIRso): W +t-q op K'r,„ 'CITY QF EVERETT BUSINESS LiCENSE#(REQUIRED): 05 t9�`7�"J <br /> • <br /> PRIMARY CONTACT: 0 OWNER (: CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME,,,. CONTACT PHONE: (1/2- 487.3 <br /> -L/S7/ <br /> V <br /> cC I dmt� S CONTACT EMAIL: tdi iitlk}'7f1.-%`}t:..c 6inielL-,Cat <br /> BUILDING PERMIT APPLICATION <br /> Ih <br /> Existing Use of Building: Contract Price of Work:$ U <br /> - <br /> Proposed Use of Building: Heat source: ❑Gua L' otrie ❑Othor <br /> Building Type: ❑SFR-Cetached OSFR-Attached ❑Duplex I�MI:1ti-Family-# Units: <br /> ❑Commercial ❑industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair OT.I. ❑Sign ©Sprinkler ❑Demolition DChange of Use <br /> DESCRIPT ON OF WORK: f E-kcy---oc <br /> UIMP-11.—.°1fr(S) <br /> ) <br /> eirooi,,E. Q1_,Itpiget <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New _. Addn _Alteration Repair Type of Project: New •_Addn __Alteration _Rep 5 <br /> #of #of #ofList of Fixtures #of List of Fixtur <br /> List of Fixtures List of FixturesFutures <br /> Fixtures Fixtures Fixtures Backflow Preventer(inside Bldg) <br /> A/C Air Handling Units Haat Pump Toilet <br /> Forced Air Systems Unit Healer Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Refrigeration Shower Floor Drain <br /> Water Heater d Kitchen Sink&Disposal Gas Fireplace Grease Trap Wood Stove <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas - <br /> Range Hood / Water Heater Other: <br /> Exhaust FanSink(Service/Bar/Mopletc.)4 Other: <br /> • SPRINKLER!SUPPRESSION SYSTEM <br /> ]Number of Heads <br /> ACKNOWLEDGEMENT:I hare reviewed this eppticatlon and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> currant redemt state,and iocO taw The prnntinp of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized In wilting from the <br /> Building Official before being authorized under any oircumstanus./am the owner,art am authorized by the owner or this property iu inn roar the werh for which application is made. <br /> an 1 comply with the Stale Contractors Law 18 RCW and 296.200A WAC. City of Everett Official Use Only <br /> ( IP, - 7-// LP RMlrfl: <br /> t -a 210 I <br /> � <br /> 0/Authorized Agent Eignotura Dem (Revised a <br />