Laserfiche WebLink
MPERMIT APPLICATION <br /> BUILDING / MECHANICAL/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 I(E)everetteps@everettwa.gov I www,everettwa:govlpermlts <br /> (Blue or Black Ink`Only Pleases ' PROJECT•RITWIWPaiiIMAtiON <br /> f <br /> PROJECT SITE ADDRESS: '"/ .5 Niles es.? PROPERTY TAX#: <br /> LEGAL for;low:on;`.ruction: Short PIaU>ubdivl;ion <br /> Lo No. _ ]attach ropy of long legal description) <br /> CONTACT:I <br /> OWNER NAME' a # T 1 <br /> --.MA Ir ►, TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: ;a- I <br /> c.ris <br /> 4 0 w P=- <br /> ,,-ATt, Ak. r-!n "'r4),tir',• <br /> ,d <br /> OWNER PHONE: j 4r. 1 3� 3 OWNER EMAIL: <br /> CONTRACTOR NAME: CITY) Igeak rl4n C <br /> CONTRACTORADORESSS7REFT 14 o ^ y r n } , <br /> CJ ry G. `,^Wt Q(J <br /> STATE A-- zip LD z.0 I <br /> ivONTRAG70R PHONE: L �r� <br /> 0 CONTRACTOR EMAIL ,.#...At # t, to Ala i of Ir nt .care <br /> ' '+t" '� --erfY BP-EVEREtTS BUStNtSS-LICENSE <br /> bo��tz�r-aR�1c�Ns�i€��2EQt:fI;2E� R' - #tR'EQettREur: tit6art-g --. . <br /> PRIMARY CONTACT: 0 OWNER 11` CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> CONTACT PHONE: �� GS 2-CJQ 1_ � �G}}' <br /> CONTACT EMAIL: -an t..t,.a e �y1bt,ect,"->±. .Co <br /> sBtfII;DING iI=LRMft'rA�'I* 1t'1 "t'iCil��"*r�'`A-�;� ci,.. : T <br /> Existing Use of Building' __ <br /> "raprsse3 Use of Buildln : " <br /> Heat Source: ❑Gas PAP tri ❑Other <br /> Building Type: R-O tat heti ❑SER-Attached ❑Dupiax ❑ gr Mufti-Family- of Unl <br /> Type afP,ole + Ft <br /> QVpw ❑Addition ❑ ,mcdol ❑�, t ❑Commarcia! ❑Industrial _- <br /> DESCRIPTION OF WORK: DTI ❑sign ❑3pri,^kir ❑Demolition ❑ fi n a of Us> <br /> t ns+a I l v\f - wiNAF <br /> ASSOCIATED BUILDING PERMIT 1*(cif applicable): <br /> MECHANICALPERMIT CI'I'-APPLICATION- '' <br /> =irk y <br /> New t ;-'PLUMBl(tOriw.ERMiT P,".. IOATION <br /> Type of Project: Ne <br /> Alteration Repair <br /> Li f 'Of Type of Project: New Addn _Alteration Repair <br /> o �.-.t?1.�.lXaLiFO.S._._._ ._..fsQ.AtF•-�YlticB.&--.. ...... #of <br /> 1111111111 �trlxr�uras Fixtures —Ljj`atFl #of <br /> NC-Air Handfin Units +��' Fixtures LrsEofFlzruras <br /> MO Forced Air Systems Heat Pump Toilet <br /> MN Unit Heater Bathtub Urinal our Preventer Inside 11.67 <br /> Gas Piping Urinal <br /> Boiler Lavatory(Wash Basin) <br /> 1 Flooring Fountain <br /> ��e�d9eratinn Shower <br /> �r Floor Drain <br /> I"��� a�' �. p cod Stove Kitchen Sink&Ois.osai Grease Ira. <br /> Clothes Dryer Haoku.s Dishwasher Roof Drains <br /> 11.1.1 Range Hood 11111.1 <br /> 7ther: Clothes Washer <br /> Medica(Gas <br /> � Water Heater Other. <br /> Sink Service/Bar/Mop/etc. Other: <br /> SPRINKLER'/SUPPRESSION SYSTEM ;: <br /> No.of Heads <br /> ACI(niOWLEGGEMEfvT-I have reviewed this application and confirm the/nrorgnetrart ccnrained hewn is true and correct.Work dons pursuant to this permit must comply <br /> rtrrcrent tade€rat stare,artd iciest law. Tf>e grarailng:% � <br /> curreng o riel slme, nd l f eural only auihcrtaes approved work aeda deviations therafircm GevlaI/cps ust first be atilt coxed in writing from with <br /> Inn <br /> g authorized urger any circumstance I air the o e7, iic ''/' <br /> arc/1 comply with the State Cortractcm Law 78.27 RCW end 2d6.2COA WAC, -Crr!OM suit Cid xed h r the Omar Cf this ro erty to laerfvrirr the vrrrk for whi le 3 <br /> FFdeaHcr°rs rt:+�ea�; <br /> q City ooff Evlerett Official UsseeOOn/yy <br /> 4. C f PERM1QI,T� f� C� lO W <br /> Cw•ertAuthcrized Age •s!1 1 Y, 1 <br /> 9 Signature C 1 <br /> Cate (Pet/m(4d Sr2312ciej <br />