Laserfiche WebLink
1477 PERMIT APPLICATION <br /> BUILDING ECHANICAL / PLUMBING / SIGN / 2INKLER / 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 I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:rcci nb w 1)1A/17 PROPERTY TAX#: ' b�1 0 '.1\ op Z 00 S 0-0 <br /> LEGAL for new construction: Short Plat/subdivision_ _ Lot No. (Tattach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: aV Y-5 age.1121441(.. TENANT NAME(If Commercial): 6KKV, CO-e47, <br /> OWNER MAILING ADDRESS: STREET (j o e 1O ¶ zi,Ni b <br /> / <br /> CITY �j\J 12t STATE 4,1 Vi ZIP 9 210 3 <br /> OWNER PHONE: ( OWNER EMAIL:n <br /> CONTRACTOR NAME: �j e&.Q �NJi (i�ark SgLvi(.e -S <br /> CONTRACTOR ADDRESS: STREET 15 D D 10 1j1 Q -\IL S A yy��JO <br /> CITY ( G' STATE (4 ZIP 1 V S <br /> CONTRACTOR PHONE: IDLO — (oi 1 -g i 1 CONTRACTOR EMAIL: f\i‘a÷& C f eAp ---i") , t0PV\ <br /> CONTRACTOR LICENSE#(REQUIRED): 1 Kg W CA°M LC,3 CITY OF EVERETT <br /> �'"ABUSINESS IICENNSE#(REQUIRED): 0 &Z. <br /> PRIMARY CONTACT: ❑OWNER ❑ CONTRACTOR OTHER(Please Specify) h1 t i_71 (IrkA - \ Acth I e 3) <br /> CONTACT NAME: CONTACT PHONE: 44. S.'' c6SS--4300 <br /> 6V{e4, ¶Vh'I I t?/(1CONTACT EMAIL: 6,)(Ai it NI CI1yNY"T.t26►'11+6c/-S. torA <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: -4 (`� �j Contract Price of Work: $ 1 G L U . C' L' <br /> Proposed Use of Building: (,( ‘t T3 tt Heat Source: 1=1 Gas DElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: DCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> D SCRIPTION OF WORK: <br /> vt C-R6AV -A-V /1 1 N+ ibt + 1 tvlaott Yrk, + NOSIG1. Z 5'i coos W J N <br /> AOS boo�511 ►p►l RAOP (/• ► ) )I- 3 . <br /> ASSOCIATED BUILDING PE MIT#(i applicable): <br /> MECHANICAL PERMIT APPLICATION I PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration Repair Type of Project: _New Addn Alteration Repair <br /> #of #of <br /> List of Fixtures #of List of Fixtures #of List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> _Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping _Boiler Lavatory(Wash Basin) Drinking Fountain <br /> _Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace _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 /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads <br /> 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 <br /> 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 <br /> Building Official beforOeing 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 /> and I comply with the Stbte Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Offict vaial Use Only <br /> <' PERMIT# ti <br /> 01,2_, <br /> z3) ) 1, <br /> .... <br /> ----- <br /> ---.. <br /> Owner/Authorigent Signature <br /> i�d Aate (Revised 10/12/2015) Y _ <br />