Laserfiche WebLink
• <br />PERMIT APPLICATION <br />EVERETT <br />WASHINGTON <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 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: IS 1F%xMjnv.K <br />Ndom <br />PROPERTY TAX #: 110992 <br />3Z„00 Q <br />LEGAL for new construction: Short Plattsubdivision <br />Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Co-4 r <br />TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET <br />Z. <br />CITY <br />STATE <br />ZIP <br />OWNER PHONE: Z — L— <br />OWNER EMAIL: J.ySiQ <br />w <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: STREET <br />" CITY <br />STATE <br />ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />CONTACT PHONE: <br />CONTACT EMAIL: <br />BUILDING INFORMATION <br />Existing Use of Building: J3 t#*0 <br />Contract Price of Work: $ 4) <br />Proposed Use of Building: UoAa4Heat <br />Source: IRGas ❑,,--,Elletectric ❑Other <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: 260mmercial <br />❑Accessory Structure <br />Type of Project: []New ❑Addition ❑Remodel ❑Repair <br />19fl. ❑Sin ❑Sprinkler ❑Demolition <br />❑Change of Use <br />DESCRIPTION OF WORK: . 1 <br />Rtmova *K%4bki.�q S�ooserS 1 v► ba. radLKS <br />2 MICA.) At>A Yv4V# o%A4> ow• " skoc,jc.r <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />fetid tiv«, c+r�� <br />'&ti►aVJdr. <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 />F' ure <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, mho <br />Boiler <br />Gas R e <br />Clothes Washer <br />Sink-C ercial (3-comp,prep,floor) <br />Clothes Dryer <br />Pump&Ductless <br />Dishwasher <br />-Residential (kitchen, bath, bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type I <br />Hose Bibb <br />Urinal <br />Exhaust Hood (T II) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Ho (Residential) <br />Wood Stove <br />Interceptor-Sand/Pr <br />Water Service (behind meter) <br />Forcej,Arr Systems <br />Other: <br />Medical Ga <br />Water Valves or Fixtures <br />G ireplace/Insert/Log <br />Roof Dr ' s <br />Water Heater <br />RINKLER / SUPPRESSION <br />SYSTEM <br />S104ge Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />No. of Heads <br />Chemical Suppression System <br />No. of Heads <br />ACKNOWLEDGEMENT.- / have reviewed this application and confirm the infopihkion 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 l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PER72,XZ J 2 <br />wner/Authorized Agent Signature Dat (Revised 1011012018) <br />