Laserfiche WebLink
T �I'I PERMIT APPLICATION <br /> BUILDINJ-J-'WECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION <br /> E V E R E T TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I 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 /> PROJECT SITE ADDRESS: 3i Z e i3 regotdw pt0Zb 1 A. ZG(D PROPERTY TAX#: 0629 5-7 3 9 Z.5-000 I <br /> LEGAL for new construction: Short Plat/subdivision j Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: C:de i'€# C7a4f.v.Ay, C..Qyt-6, 1,1,6 TENANT BUSINESS NAME(Commercial): 6 6 leaja1 Cekt, <br /> OWNER MAILING ADDRESS: STREET g LZ(, 6eaaJ(Aay -thy—,e, Zo / czc20Go. <br /> r <br /> cm( f ,9 g,r ke if STATE w. ZIP Cl e2,0 I <br /> OWNER PHONE: ti ZS 3 1 L_. 51/ OWNER EMAIL: <br /> CONTRACTOR NAME: if J IS CUyt�1 ,IV IA... <br /> CONTRACTOR ADDRESS: STREET OZ 807; Lt:A0 t-.ke, fro A-. <br /> CITY S'iit o lta ig/sGL. STATE ki i+ ZIP q 0 1 6 <br /> CONTRACTOR PHONE: Ze21 .7 c1 3 Q /1-1-7 CONTRACTOR EMAIL:a 14)1(to d? 4144- e' vu5-/2,ca Hz_ <br /> yr- <br /> CONTRACTOR LICENSE#(REQUIRED):As? co C I"' iOt,i' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6,96,s/ <br /> PRIMARY CONTACT: ❑OWNER pfs0ONTRACTOR 0 OTHER(Please Specify) <br /> CONTA T NAME: • _ CONTACT PHONE: 0 0 6, --2q 3 0. (4-17 <br /> r <br /> ato� 0 l 4 yah erp(/t. CONTACT EMAIL: G_h 1 I kt(4 h,E t-m 6 4/60 • eG il- <br /> / BUILDING INFORMATION <br /> Building: P1 1c 2/ 'Ztty, 443) <br /> ExistingUse of y DQ Contract Price of Work:$ (�/90,..Proposed Use of Building:1 A/c f ad l'itariat y d. 1�X-0l �, Heat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR OTownhouse ❑Duplex LJADU ❑Multi-Family-#Units: commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair KT.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: ,/j �� 9\Go- � <br /> /-�- -6 eXts-1-- c,,-Lacc... A9-0-e., o't-ot-t-vL c1.mor. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION __- <br /> Fixture <br /> --Fixture Fixture Fixture Fixture <br /> Count List of Fixtures court List of Fixtures Count List of Fixtures _Count Li fixtures <br /> A/C—Air Handling Units Piping- Backflow Preventer(Inside Bldg) Sho ub,or Combo <br /> Boiler s2ange Clothes Washer i k-Commercial(3-comp,prep,floor) <br /> Clothes Dryer `p� at Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) ?(" Refrigeration Drinking Fountain / Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(R= idential) Wood Stove Interceptor-Sa •ii Water Service(behind meter) <br /> ZForced Air tems Other: Medical G-: Water Valves or Fixtures <br /> Gas Fi •.lace/Insert/Log Roof Dv-ins Water Heater <br /> SP- KLER/SUPPRESSION SYSTEM : .ge Ejector or Sump Pump Other: <br /> Water Su..ression System No.of Heads <br /> Chen?-•.•:l Suppression System I 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 /> I City of Everett Official Use Only <br /> 1 ,/// �� -� 7^ 1`t PERMITl�On '(9O <br /> Owner/Au orized ' . Signature Date ( (Revised 10/10/2018) - <br />