Laserfiche WebLink
. <br /> 4477 PERMIT APPLICATION <br /> BUILDING I MECHANICAL 1 PLUMBING i SiGN/SPRINKLER I DEMOLITION <br /> CiTY or EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everettepsOevereuwa.gov I www.everettwa.govipermits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION 0-19140, <br /> PROJECT SITE ADDRESS: too L(i 3 7 4L S t �+Y 'PROPERTY TAX#: oleo <br /> f eo <br /> LEGAL for new construction: Short PIatlsubdiviston _„ tot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME &1JIL25 TENANT NAME,` If Commercial): <br /> OWNER MAILING ADDRESS: STREET 4 p/�7 ylJ +� ,f Vi ;,7- <br /> CITY <br /> , <br /> CITY Y,K..irt-1 .. .. STATE A'Pr= ZIP <br /> OWNER PHONE: 4/6—n-1, i . .' _ ..I{ `� 0WN,R EMAIL: .---— . <br /> CONTRACTOR NAME: UI/S AJ&) iN JA)*T I A <br /> I ttAct'-�t 5 <br /> 9 g <br /> t:UN ;I u!{ uurc �6: STREET 0 �.2_ l�[(v WI- 74-i'� Cl . �� 26 <br /> CONTRACTORCITY R-erii-cril . STATE 1144 ZIP . St <br /> PHONE: rCONTRACTOR <br /> CONTRACTOR • • it )P CITY• #(REQUIRED): 06 9M1 <br /> PRIMARY CONTACT: D OWNER CONTRACTOR El . Specify) <br /> CONTACT�{��ppNAM - / p CONTACT PHONE: r —Lf.'`7/ <br /> i-cc/ a 1(- Is CONTACT EMAIL: Wf ,(,ll ,f 1„i L 6in4-it,,cf/"i9 <br /> WNW <br /> • <br /> :1. ILDING PERMIT APPLICATION <br /> Existing Use of Building: t !a'I<'r'�= ■Contract Price of Work:S_... 6• <br /> Proposed Use of Building: Heat Source: OGas ! ctric ❑other,�.,9 <br /> r <br /> Building Type: DSFR-lJetached CISFF't-Attached DOuplex bit' OH-Family-4fofUnits: Iii ._DCommercial Cllndu,5tri <br /> Type of Project ❑New ©Addition DRemodel DRepair OT.I. Dsign DSprinkier DDemolltlon C]Change of Us �l(�` <br /> DESCRIPTION OF WORK: , <br /> -c rot ( e. lq (AARK hUA-1-6Ai <br /> ASSOCIATED BUILDING PERMIT# if a.•livable <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION / <br /> Type of Project: `New Addn Alteration Repair Type of Project: _New ,_,Addn _Alteration _R•peir�6l� <br /> of hist of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures Fixtures <br /> NC-Air Handling Units Heat PumpToilet Backflow Preventer(Inside Bldgj. <br /> Forced Air systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiier Lavatory(Wash Basin) Drinkingyountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace - Wood StoveKitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting - Dishwasher r. Roof Drains <br /> Ciothes Dryer Hookups Other. Clothes Washer Medical Gas <br /> Range Hood 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 this application and c lin Hee Information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> current federal,state,and local few. The granting of a permit o !y authorizes approved work and no deviations therefrom.Deviations must first be authorized Si writing from the <br /> aulltllnp Official before being authorized under any circurnstan .I em the owner,ort sin authorized by the owner of this property to perform the work for which application is made, <br /> --- r mply with the State Contractors Law .27 RCW and 29 . A WAC. <br /> City of Everett Official Use Only <br /> Wie i tat • <br /> 6P4tPri <br /> PERMIT#NW a4,(161-6 <br /> 0 ariAuthorized Agent Signature Date (Revised 5✓2W2016) <br />