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May 08 2018 07:37AM Washington Watttttttt�eaters 8663757454 gag= <br /> PERMIT APPLICATION <br /> BUILDING I MECHANI <br /> CAL( PLUMBING I SIGN I SPRINKLER J DEMOLITION <br /> CITY(2, <br /> EVFftETT PERMIT SE WA 9820'( <br /> mEs <br /> (441gidjeerr <br /> 3200 CEDAR STREET,EVERETT, ov ,�,rh.everettwa.govfpermits <br /> (P)42g_p5'7-Betio 1 FAX 425-257-- <br /> IC <br /> `25-25T 8857 I(E)evereileps cveverettvra•9 j <br /> Please} PROJECT SITE INFORMATION 000.4666001 <br /> r'z <br /> Blue or Black Ink Only 14 r EJ F PROPERTYTAX#:O� f V 3 <br /> pROJEG7 SITE ADDRESS: • <br /> +Q Lot No. (attach copy of long legal deSCIIPtion) <br /> LEGAL for new construction: Short Platfsubdivision <br /> CONTACT INFORMATION <br /> III TENANT NAME(If Commercial): <br /> OWNER NAME: an.r u) I60-)- L CabOWNER MAILING ADDRESS: STREETzits <br /> STATE <br /> -�/ -y!3Tdirt r <br /> OWNER PHONE: i -53-13- . OWNER EMAIL: <br /> +711 <br /> CONTRACTOR NAME; � t�6 � '6/2 1-1 I Gfi SCJ IDX y2,6 ' <br /> CONTRACTOR ADDRESS: sTRET 1115 Z-- (167'1A- A' LP ror � • <br /> cmr 0 STATE <br /> teff ii.CONTRACTOR PHONE: 7z J-- t 3- ► CONTRACTOR EMAIL: <br /> cCl Q f I e CCITY OF EVEREST BUSINESS LICENSE#{REQUIRED): 3 ce <br /> CONTRACTOR LICENSE#(REQUIRED): W S, I u <br /> rt%tmARV CONTACT: 0 awNFR i ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAVE CONTACT PHONE: L rOi 3-%f <br /> 7/ <br /> ) �a « ( CONTACT EMAIL: W lifi-H1,I .-@ &y Lh <br /> 04 <br /> UILDING PERMIT APPLICATION .may <br /> On Contract Price of Work:$_ I✓'""' — _" <br /> Existing Use of Building: fix- � uric ❑Other � <br /> Heat Source: ❑Gas <br /> Proposed Use of Building: Heat <br /> ❑Industrial <br /> Building Type: etached DSFR-Attached ODuplex ❑Multi-Family-#of Units:_ , <br /> Type of Project: New ♦]Addition ❑Remodel ❑Repair ❑T.i. OSign {]Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION <br /> �O�FWORK: k e_ t J,( - ! , 1t`� ,�-( df <br /> G , <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> PLUMBING PERMIT APPLICATION <br /> MECHANICAL PERMIT APPLICATION Type of Project: New Addn _Alteration .,Repair <br /> Type of Project: __•New — Addn _._Alteration __•Repair #of <br /> #of #of #of <br /> List of Fixtures List of Fixtures <br /> List of Fixtures Fixtures List of Fixtures Fixtures Fixtures <br /> Fixtures toilet Backflow Preventer(Inside Bldg) <br /> NC-Air Handling Units Heat Pump Urinal <br /> Forced Air Systems Unit Heater Bathtub <br /> Boiler Lavatory(Wash Basin) + Drinking Fountain <br /> Gas Piping Shower Floor Drain <br /> Water Heater Raefri @ration <br /> Gas Fireplace Nood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range <br /> Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood <br /> f Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER 1 SUPPRESSION SYSTEM <br /> !Number of Heads <br /> ACKNOWLEDGEMENT;I have reviewed tris 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 ly authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Rultdlna°Mrrai before being authorized under ny drowns! e,I am the owner,ori am authorized by the owner of this property to perform the work for which application Is made, <br /> . - • .••amply with the State Co rectors Law i 7 RCW a 06.200A WAC. <br /> t City of Everett Official Use Only <br /> P i . <br /> :5 u 5..... 0‘ <br /> 0' er/Authorized Agent Signature Date (Revised 5/{`20/2016) <br />