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• <br /> PERMIT APPLICATION <br /> BWWLDJNG!MECHANICAL I PLUMISING I SIGN I SPRINKLER I D EMOLITION • <br /> city OF E tERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> I (P)4'28-257-8810 I FAX 425-257-8857 ((E)everetteps@everettwa.gov I yimm,everettwa.gov/per tifs- <br /> (l31tae ct:deck ink Only 11eaise) • PRO.JEd �;IS?t INFORIUI'ifitilION <br /> r� <br /> PROJECT SITE ADDRESS: "ZS Z' . A PROPERTY TAX#> <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> tt <br /> OWNER NAME: fr.,,,Th�,a-t, .-„c / "'TENANT NAME of Commercial): <br /> OWNER MAILING aria,' 21_0 t7 it 1�'� . 4 - <br /> y.. cm( eve,„ierr STATS : . ZIP <br /> OWNER PRO : il( llif - 4 OWNER EMAIL: <br /> CONTRACT aR NAME: E UCP,C4.,564d 6174-11( fi4E INt - <br /> CONTRACTOR ADDRESS: s aeET '24 2.4) to .l AV Er <br /> MY :-,bete '( sure W A_ zip 'I'S / <br /> CONTRACTOR PHONE: 4 s5_'25"'2.-31/Li . CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED) EU5S 0214 T' CITY OF EVERETTBUSINESS LICENSE (REQUIRED) fat,//15-5- <br /> PRIMARY <br /> 15- <br /> PRIM RY CONTACT: D OWNER 11,CONTRACTOR CI OTHER Please Specify) . <br /> CONTACT NAME: CON rAGr PHONE: 425-2.$2 ,j <br /> _1 ' 7-( .. <br /> .-� CONTACT EMAIL: e . ? s +It.j r o 4 <br /> • : Brl,i it ra PtliiAI `APPucAtibi ._ . <br /> • i. ` '• Contract Price of Work: 000 .°9--' <br /> ` <br /> Existing Use�f Building: i $ - <br /> Proposed Use of Building; Heat Source: as DEleotric ,DOther <br /> Building Type: CISFR.Detached E ISFR-Attached ElDuplex DMultl-Famiiy-#of Units: r�omniei tial C{Industr€ai <br /> Type of Project: CINew DAddition EJRetnodel DRepair EIT.I. DSign DSprinkler ©Demolition, C1CIienge of Use <br /> DESCRIPTION OF WORK: is. <br /> (, c— ' MCA CGC troL <br /> ASSOCIATED BUILDING PERMIT# if a plicabl2 <br /> .MECHANICAL PERMIT APPLICATION 1 ! , PLUMBING PEIOMIT APPLICATION . <br /> Type of Project: New Addn Alteration Repair Type of Project: New .__.Adan Alteration „_repair -- <br /> #of #of hof #of <br /> List of Fixtures List of Fixtures List of FixturesList of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC-Air Handiing Units Heat Pump Toiletili <br /> Backfiew PreVenter(Inside Bldg) <br /> Forced Ari$ysfems. Unit Heater Bathtub Urinal <br /> Gas Piping Boiler f:•avafory(ilWaah,i3asfr) _ )7rinking Fountain , <br /> Water Heater Refrigeration Stiewer fear Drain <br /> Gas Fireplace ./ Wood Stove; Kitchen Sink&Disposal Grease Trap <br /> Gas Range 74 Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Neater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> . fti�INIKtrsEi ! IJ,a)� P TCI}9 SYATI YUi <br /> Number of Heads <br /> QCKNOWLED'GEMENT:1 have reviewed this application and confirm the information contained herein is true andcon`ot�Viarkcrone pursuant to this permit must comply with <br /> current federal,stale,andlocallam The gninting of a permitonly authorkes approved work and no deviations therefrom Deviations must first be atIthcezed r writing from the <br /> Building official before he/nri authorized under any circumstance.tam the iiWner,or/am authorized by the owner of this properly to perform the work for Which application le mad, <br /> and 1 comply with the Vale Contractors Law l8 2T RC-Wand 2P6200A WAC. <br /> City of Everett Official Use Only 1 <br /> "` ` 10 = <br />