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044-17PERMIT APPLICATION' I' <br /> BUILDINCIAECHANICAL/ PLUMBING /SIGN ) SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or;Black Ink OUJy P ease) , ._ PROJECT SITE INFORMATION :-A,-,:ii:.:,.. �,- :. <br /> PROJECT SITE ADDRESS: 3 Cnt y ' f L PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT,;INFORMATION <br /> OWNER NAME: M iZ` -.1- \a,rceZ TENANT NAME(If Commercial): is t,A.,(2. z -r- IA.,-z-�2 <br /> OWNER MAILING ADDRESS: STREET 00/ Co L(3Y A.,JE <br /> CITY STATE Gl,2At ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Patriot Fire Protection, Inc. <br /> CONTRACTOR ADDRESS: STREET 270 70th Ave F <br /> CITY Tacoma STATE WA ZIP 98424 <br /> CONTRACTOR PHONE: 253-926-2290 CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): PATRIFPnggCF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED : 024694 <br /> PRIMARY CONTACT: 0 OWNER I I CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ZS 3_YOS yY(o S <br /> O\ T C C LC CONTACT EMAIL: Aaks,4,1 2 Pe_Nrcr3}g re-tvw— <br /> BUILDING;PERMIT APPLICATION;:.,. .... , ,..... '- .. . .. ,...,. `. <br /> Existing Use of Building: \\c3/.tc'L Contract Price of Work:$ <br /> Proposed Use of Building: \ j c i2 Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: gCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. DSign Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> A,',. (LV To S' S T rP& ?iSS.(LS 6N FLOc S (p,7 ;is. c cs4 €),,\-,'„--.5 5j s1 e,^' <br /> ASSOC] TED B LDING PERMIT#(if applicable): <br /> 1. MECHANICAL PERMIT,APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New El Addn DAlteration EIRepair Type of Project: QNew QAddn ❑Alteration EDRepair <br /> #of #of #of #of <br /> List of Fixtures List Fixtures List of Fixtures List of Fi •s <br /> Fixtures Fixtures q Fixtures Fixtures <br /> A/C—Air Handling Units ,..1-16-a- Pump Toilet Backflow ' -venter(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Uri r- <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplac Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Ra Ducting Dishwasher Roof Drains <br /> Clot s Dryer Hookups Other: Clothes Washe Medical Gas <br /> nge Hood Water Hea - Other: <br /> Exhaust Fan Sink • ice/Bar/Mop/etc.) Other: <br /> SPRINKLER/,'SUPPRESSION SYSTEM _. <br /> 7 Number of Heads ----- <br /> ACKNOWLEDGEMENT: <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 /> Building Official 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 comply with the State Co -ctors Law 18.27 RCW and 296.200A WAC. <br /> City//off Everett Official Use Only <br /> 111111111 <br /> l ct„)) P E iv: <br /> finer uthorized Agent Signature /DI Revised 5/202016 <br />