Laserfiche WebLink
in PERMIT APPLICATI <br /> BUILDIIMECHANICAL I PLUMBING/SIGPRINKLER/ 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 /> BIur.or Wolk Ink On nesse PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: X901 M.e1I f (,>a tie, all ' V PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: UD R MG-, TENANT BUSINESS NAME(Commercial): _ <br /> OWNER MAILING ADDRESS: STREET)745 5 ''t- e/ A r <br /> CITY ' ,Lela!S &flan STATE .t► ZIP 8 41 Z <br /> OWNER PHONE: 72..02....5:13 — I,2,0 OWNER EMAIL: Wei;tAti 5Tq t 4, Q 0 T R., , Col <br /> CONTRACTOR NAME: /Tf" ,4 keit P I <br /> CONTRACTOR ADDRESS: STREET )g % frf Ips . 4\ _ OS <br /> CITY 6; &e„/'T-- STATE J4 zip 2 9_5 <br /> CONTRACTOR PHONE:036•0-20,2_ )e[5 CONTRACTOR EMAIL: Re:6er e___ QIj/ CE441 <br /> CONTRACTOR UCENSE#(REQUIRED):G,0 y^y tk—1_[y CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER /[CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: A82))513 - 773 ei <br /> M ICl‘o l f cT&. CONTACT EMAIL: 4'I L/Le. 0 r�1,4.4e),p1v,e1, cat.,,,,,n <br /> BUILDING INFORMATION <br /> Existing Use of Building: Contract Price of Work:$ 704 > ) <br /> Proposed Use of Building: Heat Source: OGas DElectric Daher <br /> BUILDING USE: CISFR OTownhouse ODuplex DADU Multi-Family-#Units: OCommercial OAccessory Structure <br /> Type of Project ONew DAddition DRemodel ORepai OT.I. OSign OSprinkler ODemolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> Rep c_Pv 6.. w `'- pipe_ itis iPe 1 1P-e-) i 1 ke- .4(" 11 k_ <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> FbrWreFixture Fixture <br /> List of Fixtures Rxture <br /> Count coma List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) 31 Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless a7,9 Dishwasher 75 Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain 2_14 Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water 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 I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System I 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 bei : ,.uthorized under any circumstance.I am the owner,or I am authorized by the owner of this properly to perform the work for which application is made, <br /> and i comply w h the St,...„/C tr= tors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> !% AP PERMIT <br /> r (0 1 i --00r <br /> Owner/Au oriz •'r,tent ignature Date (Revised 10/10/2018) <br />