Laserfiche WebLink
'.-..--:"-:. -.i r <br /> 'l''/' .-''� ' EflJH...DIING / �4a �:oC-� -UNOCAL. IG`�-� .. �V�i NGISGNIc5G' d �`�9G'a,F I .:DhdlK)IL.Q'llQ� Ni��f <br /> --; <br /> CIIY OE=EVE:RET PERMIT SERVICES <br /> . ,,,,,,,,„,,,--. <br /> 3200 CEDAR STREET, EVERETT,WA J8201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ([Mane orr Black t k 'S�n@y Ple ase) _�_ —`PRLi)JI�C N' SI`Tt'IE IE�G�O� Ila'iA'i1T'I®fa`�7 —_-- --- <br /> PROJECT SITE ADDRESS:f D72.3 ,4, l 9 ' 7 /'�. ci. ,� PROPERTY TAX#: ZS o j-'f j,3 <br /> .i... <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) �] <br /> r <br /> CONTACT INIPORMATION <br /> `OWNER NAME: wE',4' / v/A ?%/�/,� TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET /b3 q 47 <br /> J7rl�e7. <br /> CITY B�-Lc•[�t/v�/ STATES ZIP (� <br /> OWNER PHONE: - OWNER EMAIL: t rt t. <br /> CONTRACTOR NAME: .17 <br /> I <br /> �CONTRACTORADDRESS: STREET <br /> I <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR �' eTHER(Please Specify) h 7z .t-( ("7 c J <br /> CONTACT NAME: o5 - f•�--,M,tsS t f� CONTACT PHONE: (4 Z,,,�') 5'Z _ 1- r J 3 <br /> --�I'�'Z. /�CLc.l jg -�rcl•-r C?�+TL�- CONTACT EMAIL: ' •SS Z-1 ZG�,r-c�..Fit- -` .Lq�,� <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: S t h.S !- c'—t',�p+�-e H &. _ Contract Price of Work:$ <br /> Proposed Use of Building: 'r o r-N H mot. Qr- Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached I'-ibFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Pf (' oJ S7. 12 vJVI? Tow N fib �.S''� C�rt /' LI.' .K, <br /> ASSOCIATED BUILDING PERMIT#(if applicable): hl d (q !J' <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New _ Addn Alteration _Repair Type of Project: _-New _Addn Alteration Repair <br /> #of List of Fixtures #°f List of Fixtures #°f List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump 2. Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems l Unit Heater I Bathtub Urinal <br /> Gas Piping Boiler 2. Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration I 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 I Clothes Washer Medical Gas <br /> f Range Hood I Water Heater Other: <br /> 3 Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM _ <br /> Chemical or Water ➢ 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 l 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# a�� 'D �� <br /> OwnerlAut orized Agent Signatu e Date (Revised 9/23/2016) <br />