Laserfiche WebLink
• <br /> PERMIT APPLICATION <br /> BUILDING 1 MECHANICAL I PLUMBING/SIGN I SPRINKLER I DEMOLITION • <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps©everettwa.gov I tNww.everetfwa.gov/permlta . <br /> (Riede or lilr.Ck lifik®si11f.eIease) • PWWJEO SII,T ItNF®,I ntwMrko . .. • <br /> PROJECT SITE ADDRESS: j, , i, ...... A M yid PROPERTY TAX#t: I+ <br /> LEGAL for new construction: ShortPlat/subdivision Lot No. (attach copy of long legal description) <br /> 1 . • •CONtACT INFOliG T TI(®k�l <br /> OWNER NAME: -6:--A., 441_ TENANT NAME(If Commercial):... • <br /> 1CITY <br /> iOWNESTREET , , 1 •-- ..rA f......) . <br /> a;7:11 '..( STATE 1 ,4 ZIP 4.9? I <br /> Q , <br /> OWNER PHONE: 4 w_..,_,...... OWNER EMAIL:„ irk, .Q!`a?s/7. ,-0 <br /> CONTRACTOR NAME: E CR <br /> .G.W AJ 6`c—0,-70.-- 'Jb cerL ` <br /> CONTRACTOR ADDRESS: STREET '2-II O .tel ft-e- AU g p <br /> girtS.�/�YW 6 { STATE (�f,!fk- ZIP (I�' / <br /> CONTRACTOR PHONE: 4 s-5.-2.5 2..r5/! • CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): casit24. s p2.so^f•• CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): C5 6 r j <br /> PRIMARY CONTACT: °OWNER IACONTRACTOR El OTHER(Please Specify) • <br /> CONTACT NAME: CONTACT PHONE: 14 75-..2,5 2.a,/f 9' <br /> A/6---4.) Sitto CONTACT EMAIL: y /—iir <br /> i3 FALArStG etAlcirr APP.L[CATkON - <br /> Existing Use of Building: 1 Contract Price of Work:$ L` 60 <br /> Proposed Use of Building: Heat Source: ElGas 1:1Electric ElOther <br /> Building Type: EISFR Detached CISFR-Attached/ l duplex 12Multt-Family4 of Units: °Commercial °industrial <br /> Type of Project: °New °Addition °Remodel i Repair °T.I. °Sign °Sprinkler °Demolition ❑Change of Use <br /> DESCRIPTiON OF WORK: Ck+A,a,cG ©tc!" 4S rmt2 G✓ tot <br /> T o. I • 106 A(2 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> ! • : .•11/(Eclf(AkiCkL,1151?Rm1T APPLIC TKON • , IPLUIli.l.dlINGI,Oagiifirt AP P ILIICATIION <br /> Type of Project: _New Addn Alteratld?epair I Type of Project:__,New p Addn Alteration Repair <br /> #°f <br /> List ofFixtures #of List of Fixtures ' °f0 #of ! <br /> List ofFixtures 9 List of Fixtures <br /> Fixtures , Fixtures Fixtures Fixtures <br /> ' NC—Air Handling Units I Heat Pump i Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal • <br /> i Gas Piping <br /> Boller 1111 Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower _ Floor Drain <br /> Gas Fireplace 71 <br /> Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/Mop/etc.) Other: • <br /> : .• IP:fi9 Y, LEE 1 XYPIPI.E.. r®NY s)rrmiw ' i <br /> )Number of Heads <br /> CKNOWLEDGEMENT:l have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> orient federal,state,and local law.The granting of a perrnitonlyaufhorizes approved work and no deviations therefrom.Deviations must first be authorized/n writing from the i <br /> inkling Official before being authorized under any circumstance.lam the owner,ori am authorized by the owner ofihls property to perform the work for which application is made, 1 <br /> and/comply with the ate onfractors Law 18 7RCW end 298.200A WAC. <br /> City of Everett Official Use Only <br /> .I g'--12-('p I i'1Mt� " b,24 <br /> veer/Authorized Agent Signature Date (Revised 6/20/2095) ' <br />