620 112TH ST SE SPACE 9 2019-08-16

APPLIATIOM IT BUILDIN!/ MECHANICALS PLUMBINGOLT PM /SIGN SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION c PROJECT SITE ADDRESS: [F26 [1-74 sr: 3A q PROPERTY TAX#: 2 secs Sr 1003Q2.x��-'C LEGAL for new construction: Short Plat/subdivision 1 Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: f iv U be Pt 4 ((I A-L[CrENANT NAME(If Commercial): JkPE'L /10446— OWNER 1044 'OWNER MAILING ADDRESS: STREET -742_40se 2-7 7-ti s'('e cot T-F- /2 CITY /VBG YL(. 15i.,+} STATE 1/1/4.. 4ZIP 9.Bc4 OWNER PHONE: c' 941 842_, OWNER EMAIL: .T'vtiE OP ATit'�A-R-i -L-E T rE.& M CONTRACTOR NAME: RAI NI(- srI~.Uc p....--CSI,,L, C1 CONTRACTOR ADDRESS: STREET 74 24 • E- 2-7sl--. Suir CITY AA LC- ' ._ /S 1'f•j STATE ft- ZIP q 60%2 CONTRACTOR PHONE: 4/2. - 2 s i.-()Gut_ CONTRACTOR EMAIL: ari f l� me I. Q) CONTRACTOR LICENSE#(REQUIRED): k /s'*96 3 ai CITY OF EVERETT BUAESS LICENSE#(R QUIRED): PRIMARY CONTACT: 0 OWNER iirCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 2s-- (_ 66 4th Cl eb 0(' r CONTACT EMAIL: C I.--e_,< i I ,Co 1 BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ $2_0I 000 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair CIT.]. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: /14 STA/4.-4'1.--70l C NE-LA-) Mit vft-e-2v 2 i-loNt.c" iN W E) :rid c� 5LaT ire Mfri4 . tt'ivtZ Pte- C2.A-4o oE- AA-TA- lC, .) ASSOCIATED BUILDING PERMIT#(if applicable): A-1,00 fa t snips 6.£ s oru- ber-- MECHANICAL,PERMIT APPL_ C ►TIAN,,, , ,_1_I._. PLUMBING PERMIT Ap LIGATION. Type of Project: _New Addn _Alteration _Repair Type of Project: _New _Addn Alteration _Repair Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater 4. Other:tAJ 1l()1_e4/4. Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM 6 Y-414) Chemical or Water I No. of Heads 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 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 Building Official before being authorized under any circumstance.I am the owner,or t am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. ''�^^\�� City of Everett Official Use Only 9 `t— 1 �1 PERMIT#O i� WOO 1 Owner/ ut rize gent Signature Date (Revised 9/23/2016) .,-- s\ iIa