Laserfiche WebLink
0 <br />EVERETT <br />WASHINGTON <br />0 PERMIT APPLICATIO• <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAY, 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue ea, Wark Batt; Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 611 � 6-VERCTF /AAt-L WhY. 5iE I A EUGRCT7 <br />PROPERTY TAX #: 2i3d5 1900 -7 q00 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: RM2J PPOPC-RfA&4VA6C iNGvi ,v,tata TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET 629 2-52" P,_ /td C <br />A1,9 <br />A �! ?9 <br />CITY -a��li.+ wjN ) STATE NqA ZIP ��t" 053 <br />OWNER PHONE: 206 902 ! 33& <br />OWNER EMAIL: 6'F/lri to ¢r� Viu PM4i 0 Cetsh <br />CONTRACTOR NAME: 864 /-/ 1V612711W (S _r <br />CONTRACTOR ADDRESS: STREET 2,7/O / py7N S7 C.%= S <br />© 9l <br />CITY I-AKC Woo D STATE WA ZIP 578k/ rp <br />CONTRACTOR PHONE: 25', "5 70q t <br />I CONTRACTOR EMAIL: b6osn .n C o M <br />CONTRACTOR LICENSE #(REQUIRED): 1-/Fg7f-1MZ'76l 3 2 <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED):4lb>7 <br />PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />8R/A)V BROSalVAN <br />CONTACT PHONE: 25-1 IMS -70qt <br />CONTACT EMAIL:bbrosaco 60 e_o, no Wes < co�� <br />BUILDING INFORMATION <br />Existing Use of Building: V, �-_ r' 1 <br />Contract Price of Work: $ &W <br />Proposed Use of Building: Q67/41L <br />Heat Source: []Gas ❑Electric ❑Other <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: krcommercial ❑Accessary Structure <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. XSign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: Inc,-rAL,L CI) S/Ire 11-L- '-1l-V4760 W,TLA— WL+-4JS lZ(\401Z)G °' T- n0,6/GC tr <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C - Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen,bath,bar) <br />Duct System (Remodel) <br />lRefrigeration <br />l Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not HeatlAC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />WastelWater Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/insert/Loy <br />Roof Drains <br />Water Heater <br />SPRINKLER I SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System I <br />I No. of Heads <br />Chemical Suppression System I <br />INo. of Heads <br />ACKNOWLEDGEMENT: / 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 1 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#�S0 � (J I 1 O_ oO� <br />(Revised 1011012018) t <br />