Laserfiche WebLink
PERMIT APPLICATIO <br /> BUILDING I-MECHANICAL I PLUMBING I SIGN I RINKLER/ DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (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: q•tQ 0 14 Pit? a..L , 3 L- L l C. PROPERTY TAX#: ?.. 0 5 \$0() 1 G? I. ?o a <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: sq j:—(tA isA.,.Arrtabrad 19.0k itol 4 p TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET r)0 0 7i FT,/ 4') j ('tT ; --) <br /> CITY ►- ss; 1�� `"' 3 10``� <br /> e* { STATE ZIP <br /> OWNER PHONE: :a0 P ''i c { -5`''1 i OWNER EMAIL: <br /> CONTRACTOR NAME: ,} 0,, ,G,;; 14.c.,SO q' I <br /> CONTRACTOR ADDRESS: STREET %1 p Z')O �/ 6141Iv o r-E g <br /> 5CVO T <br /> CITY .a #. EW U.l r'.. STATE / ) ziP ` "z,"'xi 4 <br /> CONTRACTOR PHONE: Ci i - --01 5 Is CONTRACTOR EMAIL: j7 H.+C;^. \?y ,, .L.`" ,i' .. I)/'', <br /> CONTRACTOR LICENSE#(REQUIRED):aWi T r:p,\Z�i9,a c CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): F1 7-3 @`- <br /> PRIMARY CONTACT: 0 OWNER ( CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2 O 6 _<6 5' _G?.,' ' . <br /> ?' lL'.a° tO''!9 D CONTACT EMAIL v ,,, t"At-fi t 44 .r <br /> BUILDING INFORMATION <br /> Existing Use of Building: 4 t,pfv'°F"; > , ;'j '', 1 Contract Price of Work:$ /6 Z-'G <br /> Proposed Use of Building: Pa' 4')=°, if -pro t L;'y Heat Source: OGas C lectric DOther <br /> BUILDING USE: ❑SFR ❑Townhouse --❑Duplex ❑ADU L�ulti-Family-#Units:3 v- ❑Commercial ❑Accessory Structure <br /> ❑ // <br /> Type of Project: New ❑Addition Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler El Demolition OChange of Use <br /> DESCRIPTION OF WORK: 6 `Al c i i u I 1 �t 1' . :..o p 1 , "" " 1 _ iz., O <br /> ASSOCIATED BUILDING PERMIT#(if applicable): i\) IA <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture . List of Fixtures Fixture Fixture <br /> List of Fixtures <br /> List of Fixtures Count List of Fixtures <br /> Count Count Count <br /> NC—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 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/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.1 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 /> 67 .' /77. /2‘) PERMIT#3 1,-4 <br /> On <br /> Owner/Authorizetit Agent Signature Date (Revised 4115/20fgj <br /> i <br />