Laserfiche WebLink
imi- Y Y 1 PERMIT APPLICATION <br /> 11. <br /> BUILDING ECHANICAL I PLUMBING /SIGN I ,��"IN LER I DEfviOLmO l <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: /yDZ /Zee/ E F (�[.,/ -/Z h16_ PROPERTY TAX#: exici 343 c Z9/0 3,co <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 6//4A5�,arr1 #61�' TENANT BUSINESS NAME(Commercial): gyp[-///>' r ArAeSvti7/bit� <br /> OWNER MAILING ADDRESS: STREET /!'Z/ A/6 /e67N g7 <br /> CITY 5/-fo �/N.� STATE /,,JA- ZIP /S f <br /> OWNER PHONE: 'lO -74'4—/S Z r OWNER EMAIL: /NFD ® -vOLtJEpRo�I=iz'Tf 1PR�S Gp�l...,. <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: C(�OWNER ❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: tar, 7q.� s�Z.s� <br /> l%U S hd e7V,/ CONTACT EMAIL: /NFvr 6i 4vdGvepggi,�rCT)/ 0,05. GO�t <br /> BUILDING INFORMATION <br /> Existing Use of Building: f jZ_ Contract Price of <br /> Work: $ 12 S 000 • r`) <br /> Proposed Use of Building: /2 L�Heat Source: Gas ❑Electric ❑Other <br /> BUILDING USE: t¢ FR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition U Remodel dRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> jZFjs/O ti/h7 RA .,•Nglwk iTa H � I./r77-0,S, e-c,tee 2/A, 07 . I NT'r/a/ole--- /. ",iA/7 Ex i 1 /An; <br /> tooF itFC'f*1/? <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) 3 Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless / Dishwasher a 7-f Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> 3 Exhaust Fans(Residential) Commercial Ventilation Floor Drain ..yr 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 1 ` <br /> cf. <br /> Owner/A rized Signature ((0i/-ZO <br /> e (Revised 4/15/2019) I <br />