Laserfiche WebLink
477 PERMIT APPLICATION" <br /> BUILDIN ECHANICAL / PLUMBING / SIGN )'SPRINKLER / 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 /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:. 7 f� Ave.. 5� PROPERTY TAX#: Z lex Za9/OD <br /> LEGAL for new construction: Short Plat subdivision Lot No. (attach copyof long legal description) <br /> ) <br /> CONTACT INFORMATION <br /> OWNER NAME: Sp. foary 44„yd;'e,„ P S,,, TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET Vt 1 L / Ve. E <br /> CITYV,wy, STATE �nI' ZIP leZ O <br /> OWNER PHONE: OWNER EMAIL: rCnht k t v10� sv iwt pc riSk . orO� <br /> CONTRACTOR NAME: &1 \A�{e ' J (Vn J J <br /> CONTRACTOR ADDRESS: STREET ?,)\05 reaoLu kt/ I <br /> CITY LL1Tier STATE �y .' ZIP O`�2697 <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER ❑ CONTRACTOR El OTHER(Please Specify) <br /> CONTACT NAME:A/'r J / 4 ik",-. CONTACT PHONE: 42—2 f% C) <br /> 7 - 6G'j1CONTACT EMAIL: l.7?/ !C S (6' /-7i ///Li C-/7 ,CC y-y-l <br /> BUILDING INFORMATION <br /> Existing Use of Building: C`n.IJ'e el^. _Contract Price of Work: $ 2-1 a6C/ g ; <br /> Proposed Use of Building: Gl,1JyG L Heat Source: f3Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Commercial ❑Accessory Structure <br /> Type of Project: ❑New Addition ❑Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPJON OF WORK: Kev6ad� I aNA addlwTinh Io 1f'tte.- ed.).rot,4'fL.A, c.lAid rd..— • Wt. 1.4.4 <br /> IX I 11,5 , Si101Sr wk;cl1 will .ex of ( � cX(S+ c o� <br /> 9� <br /> 5c4 ar c V as w61t o..Sp a ; L r .—ok IA.. <br /> ►may: <br /> ASSOCIATES BUILDING PERMIT#(if applicable). <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture List of Fixtures Fixture Fixture Fixture <br /> Count Count List of Fixtures Count List of Fixtures Count List of Fixtures <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 /> Exhaust Fans(Residential) Commercial Ventilatior 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/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/ 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 /> PERMIT#� I /y ®2 O <br /> (C�/i <br /> Opener/Au6ized gent Signature �/ 6Date i��/7 (Revised 10/10/2018) <br /> q 1''' <br /> 1 <br />