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PERMIT APPLICATI <br /> BUILDIN IIIIIIIII'IECHANICAL / PLUMBING / SIG PRINKLER / 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 wwwyeverettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2.7OS /c 4," <br /> eneear ' PROPERTY TAX#: QDSSz—"MOO/ A <br /> LEGAL for new construction: Short Platieuhclonsion A._.W tot No, (attach copy of long regal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: rittni4 °" (J .. TENANT NAME(If Corrlmerctat)F; <br /> OWNER MAILING ADDRESS: STREET SAME .130v <br /> CITY _ STA'fE ZIP <br /> OWNER PHONE: %25.'32.7-- <br /> + + OWNER EMAIL: seyfai <br /> :ONTRACTOR NAME COe1V e(s1D E" & 1A,6 1NC, <br /> :ONTRACTOR ADDRESS: STREET /17((g2y /,s- -k =tot, � <br /> CAC 'C <br /> CITY +t. / ELL.. <br /> - -... _ _ ...... .. ....... STkTE LOA- ZIP 9tft)/Q, <br /> :ONTRACTOR PHONE: <br /> +�`~ 4:1-0 —.Ay CONTRACTOR EMAIL: <:twl % m at 40200,444 CO/4 <br /> :ONTRACTOR LICENSE#(REQUIRED;)e CORNier;40.14,Cin CITY OF EVERETT BUSINESS LICENSE#(REOUIRED)> O33(5-4 <br /> 'RIMARY CONTACT: 0 OWNER EK.ONTRACTOR 0 OTHER(Please Specify) <br /> :ONTACT NAME: CONTACT PHONE: > . <br /> BUILDING PERMIT APPLICATION <br /> xistin Use of Builtling: Contract Price of Work: 44 Yliatia0 <br /> roposed Use ofting; Heat Source: ❑Gas ❑Electric DOtler <br /> utt tg Type R Detached. ❑SFR-Attached DOuplex DMutti-Family- of Units: ❑Commercial ❑Industrial <br /> y te;of Prcject, ONew ❑Addition ❑Remodel ORepa€r ❑T.I. OSkIn O pint kter ❑Demolition OChange of Use <br /> ESCRIPTION OF WORK: <br /> ge,m m # 4f241,ez dl d5zt7071 <br /> SSOCIATED BUILDING PERMIT# if a vlicable <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 4111, <br /> roe of Project: New Addn Alteration Repair Type of Project: _New _Addn ,Alteration Repair <br /> Fl;cif #of <br /> fixtures List of Fixtures Fixtures ! List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures <br /> NC Air Handling Units . Heat Pump Toilet Backftovv(?revettter(Ins Id j <br /> Forced Air Systems <br /> Y Unit Heater � � Bathtub Urinal� <br /> • Gas Piping Boiler Lavatory(Wash Basin), DrinkingFountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal '` Grease Trap <br /> Gas Range,-, g Ducting 'Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer <br /> Medical Gas <br /> Range Hood <br /> Water Heater Other. <br /> Exhaust Fan Sink(Service/Bar/Mop/etc) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> )Number of uea .✓ <br /> KNOWLEDGEMENT:t have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> rent 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 /> Iding 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 /> I I comply with the State Contractors Law 18,27 RCW and 296 200A WAC. <br /> City of Everett Official Use Qr <br /> PERMIT# ) r <br /> • g "-- ?)0 <br /> tner AuthortzerkAgent Signature Date <br />