Laserfiche WebLink
EVERETT <br />WASHINGTON <br />PERMIT APPLICATIO <br />BUILDIN&ECHANICAL / PLUMBING / SIGN 7TPRINKLER / 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: Q-gc,5 4-cw' <br />PROPERTY TAX#: 00`:�;l3(r �0�E}0® <br />LEGAL for new construction: Short Platlsubdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: '_De$jej0ptvjej Ljt TENANT BUSINESS NAME (Commercial): li�Lt)"O I-oAjbs <br />OWNER MAILING ADDRESS: STREET 'Eq ( j el-2— " oojt AUt; <br />CITY EVCV21veC- STATE ZIP 4?F20/ <br />OWNER PHONE: <br />OWNER EMAIL: <br />q <br />CONTRACTOR NAME: �,�y�G'� G�CU -oA( �- 4, k <br />Ai1FL L JAO C <br />CONTRACTOR ADDRESS: STREET -Z. (2 iD .. � <br />may- <br />CITY CL! Chili { STATE � ZIP LN 2'6l <br />CONTRACTOR PHONE: l Z57- Zvi 1 - 311(I <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): ��J ��� ��. f2. Lei "� <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 5-5 <br />PRIMARY CONTACT: ❑ OWNER iq-i.ONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />rAA (IU- P <br />CONTACT PHONE: <br />CONTACT EMAIL: /t�%!f � gS^IA4 ,th <br />BUILDING INFORMATION <br />Existing Use of Building: <br />Contract Price of Work: $ /57,6d 0 <br />Proposed Use of Building: <br />Heat Source: ❑Gas EElectric ❑Other <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: 2Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: Play€ %r` �`,fr f l y _ DO7-DooX. 1Jf.•i_f <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 />IlRefrigeration <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 />I Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <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 I <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log I <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 />No. of Heads <br />Chemical Suppression System <br />I <br />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 l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Zt',z/.2-1 <br />Agent Signature Date <br />City of Everett Official Use Only <br />PERMIT # M I Z ©� 1 <br />(Revised 1011012018) / <br />