Laserfiche WebLink
471477- PERMIT APPLICATION <br /> BUILDINIAECHANICAL/PLUMBING/SIGNIPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 ( 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: 9Z r? G RA1JD AVE. PROPERTY TAX#: CO3 R54 I rJ 3O I Of) <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: JO4-IN. ,4J.ID SALLY A(T TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 9c2111 63RQN E <br /> 0 AV <br /> CITY£V{.KE r STATE ( VA ZIP 98Za I <br /> OWNER PHONE:C0-(Z5) Z 58 129s 1 OWNER EMAIL: j d I+176 C)0rio,.i I , Co vvl <br /> CONTRACTOR NAME: 1131:31 13 r j U G h,1 s)j-r j &Ms C)6(N) <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): 4 R A Lt H S C q. I°I Z g. g CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (6 J 31 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR OTHER(Please Specify) DES IU1.4 E. <br /> CONTACT NAME: Kid-NEK(N,E_ LEL M CONTACT PHONE: �2.06) g s O -9 j23 <br /> CONTACT EMAIL: Ka1-kyZe,i fri®Gj Y1 oa I O� <br /> • BUILDING PERMIT APPLICATION �jj <br /> Existing Use of Building: Contract Price of Work:$L{S i C )O GSTI N ATE, <br /> Proposed Use of Bui ding AFA Cq E.+ CF(C =f -o2ACit Heat Source: ❑Gas L9'1 ectric ❑Other _ <br /> Building Type: 'S�FR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑industrial <br /> Type of Project: I2New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF WORK: bE1- L 15(4 EX 15T(t t(a C-(A PA(tE.. s-mu c - 1,1E.(') �A A 4 E- <br /> (X1Tu 2. D grc STc E <br /> ASSOCIATED BUILDING PERMIT#(If a livable): Fz-vpicC�• .ems v_g...e_SAD...„jsc.4 CA.-4-- 0\19EdW=j1- <br /> MECHANICAL PER APPLI TI PLUMBING PERMIT A PLICATION <br /> Type of Project: New do _,,,Aiteratio Repair Type of Project: _New Addn Alteration _Repair <br /> List of Fixtur Fires <br /> Fixtures Lift of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures <br /> A/C—Air Handling nits I He Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air System U Heater Bathtub Urinal <br /> Gas Piping filer Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater efrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other Clothes Washer Medical Gas <br /> Range Hood Water Heater Other. <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> 1 <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> 'Chemical or Water ( INo.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.lam the owner,or 1 am authorized by the owner of this properly to perform the work for which application is made, <br /> and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> LM <br /> / /2 o? , IiI_ -- 0 <br /> OwnerlAuthorized Agent SIgnatur� Date (Revised 9/23/2016) <br />