Laserfiche WebLink
NM 0 PERMIT APPLICATIOS <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / 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: 89a S 1',,pp�•�• Qo� PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision i Lot No. (attach copy of long legal description) <br /> 1 1 CONTACT INFORMATION <br /> OWNER NAME: �1uk',\�t C0 JG„L.001 ✓.4,4,4ENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET et.4p % SVume a., b e', <br /> CITY EV"Itmyill..•Vi- STATE WA ZIP 12:1;•o4 <br /> OWNER PHONE: 4 x•. $1O • 41.50 OWNER EMAIL: S4��e� ,�j e1 hpuu 4G i,,.,, . wQ.,Au)r.4. - , <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED):0AVINV_* 3t3 aY OF EVERETT BUSINESS LICENSE#(REQUIRED):rx.,„a <br /> c2L..0 <br /> PRIMARY CONTACT WNER ,-❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONT T NAME: CONTACT PHONE: C4 S> glO • 1.�3 (f,,,' <br /> C1- bM CONTACT EMAIL:s\- Aso^ ;�IMun: w����.• ..PA.' U.-- <br /> BUILDING INFORMATION <br /> Existing Use of Building: ;ir\hr•,Li•S,r`r 's,..,.,vt c_a_. Contract Price of Work:$ 1pp+ Opp <br /> Proposed Use of Building: Saw _. Heat Source: / ias °Electric DOther _ <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU EMulti-Family-#Units: "ommercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair DTI. ❑Sign ❑Sprinkler Xemolition ❑Change of Use <br /> DESCRIPTION OF WORK: p 1 r. 4r 1604. 6 #Lam` hsa <br /> .ram Obyo 1J�.�-» ��'. �a�.o.n 1 t-n <br /> C.1 <br /> I,orz...r "A.A.4a..+Z VI S...\.o01 1M....\ e,...(36.w...Ai Q+". d e.. 10O••Ly✓ <br /> 4a1 1A- W..-4w <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) Shower,Tub,or Combo <br /> 1 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 Ventilatior 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/InserULog I 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 /> p City of Everett Official�Use <br /> Only <br /> l0 13 �2.c��-o PV `#Zc` ©� J <br /> ner/Authorized Agent Si natur Da(e (Revised 10/10/2018) <br /> 9 �� <br /> I/� <br />