Laserfiche WebLink
EVERETT <br />WAS14INr_'Tr1N <br />PERIi�IIIT APP ICA110 <br />BIWLDING RECHANICAL I PLUMBING / SIGN / :3'PRINKLER I DENIOa I`flON <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: `� '" " 4 t�,1 t• v <br />PROPERTY TAX #: 'ZVjQi1,00 '1001hoQ <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: CRI F U_, jENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET ` per` <br />ary cvj STATE \/J Af ZIP 1�1 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: STREET �"� <br />J <br />CITY V STATE ZIP <br />CONTRACTOR PHONE: 'W V <br />CONTRACTOR EMAIL: r <!!5 <br />CONTRACTOR LICENSE #(REQUIRED): ^j 3 \ <br />CITY OF EVERETT BUSINESS LICENSE #(REQUI D): <br />.. ..... � _.... <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR SLOTHER (Please Specify) T M <br />CONTACT NAME: <br />Vopwv . <br />CONTACT PHONE: '� _ 6cb-Z' tj <br />CONTACT EMAIL: <br />BUILDING INFORMATION <br />Existing Use of Building: <br />Contract Price of Work: $ G ` <br />Proposed Use of Building: <br />Heat Source: []Gas ectric []Other <br />BUILDING USE: EMSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure <br />Type of Project: ®New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK:��\ "N� W�p61 U�v"-� �- ►�/�� �� 2- �C� S �'�P�t•� <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 />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 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type 11) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />I <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />I <br />Roof Drains <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />INo. <br />of Heads <br />Chemical Suppression System <br />I <br />INo. of Heads <br />ACKNOWLEDGEMENT: l 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 l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PERMIT y� <br />ll� i <br />(Revised 411512019) <br />E! <br />