Laserfiche WebLink
iopp, PERMIT APPLICATION•imi <br /> BUILDINGI4 MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> _ CITY OF EVERETT PERMIT SERVICES <br /> .441 <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION - <br /> _________ <br /> PROJECT SITE ADDRESS: 10315 iCtbh Atte' / <br /> SF °Alt foit PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION .t <br /> OWNER NAME: -Iv, 1/440,0 TENANT BUSINESS NAME(Commercial): V AtakAA--- <br /> OWNER MAILING ADDRESS: STREET <br /> CRY STATE ZIP <br /> OWNER PHONE: (206-)483 - 6qig OWNER EMAIL: <br /> , <br /> CONTRACTOR NAME: —Furac./ t-IMA 2,/ei <br /> CONTRACTOR ADDRESS: STREET /3X0 0.0 ged Pad *203 <br /> CilY O (JttfiCel STATE WA ZIP . <br /> CONTRACTOR PHONE: (48)a1q-a241 CONTRACTOR EMAIL: 140)/(3 tipzifi>0 IrYlal I- <br /> CONTRACTOR LICENSE#(REQUIRED): F„Rzp 1-11874-CO CITY OF EVERETT BUSINESS LICENSE (REQUIRED. ' 0 ) <br /> PRIMARY CONTACT: 0 OWNER '''• CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 04., )2,t6i--. 2(1-' 1 <br /> littrai 1//) CONTACT EMAIL: <br /> piegeztki ria/) celr\-- <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$ <br /> Proposed Use of Building: Of+ca. Heat Source: 0Gas II' lectric 00ther <br /> BUILDING USE: CISFR 0Townhouse ODuplex CIADU 0Multi-Family-#Units: sattornmercial 0Accessory Structure <br /> Type of Project: ONew 0Addition EIRemodel , 0Repair AT.I. 0Sign ElSprinkler 0Demolition 0Change of Use <br /> DESCRIPTION OF WORK: gcr, P i 1:021) , <br /> odSa_ bA71 -IV tUt 0 <br /> _. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> FixtureFixture Fixture Fixture <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Count Count Count Count <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> , <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/VVater Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System No.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 before being 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 State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> Owner/A or.,e. , •ent - • ature Date (Revised 10/10/2018) <br /> , <br />