Laserfiche WebLink
r%'' • ::n1:'.:kIVinf:AG`:TUC: O <br /> A*0011f,41/1--' [ UB8..[TANG I lifiE:;HANk AL / PL1M!BIN( I SBCN I �3G:"Bo8NK8_.F6R I DaliCq...B'ii 80N <br /> CI-EY OF EVERETT PERMIT SERVICES <br /> q `{"/ 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 E everette s everettwa. ov I www.everettwa.gov/permits <br /> ermits <br /> — <br /> (1 km or Black link ',only Please) P�:OJI CT SITE II�FORIVIATIO6`�l _ 1 <br /> PROJECT SITE ADDRESS: fb7 2.S"C /99 147 ,4i'C • (.1. E PROPERTY TAX#: 2e G,j— i Zo3 4/0-il <br /> LEGAL for new construction: Short Plat/subdivision_ Lot No. (attach copy of long legal description) <br /> i <br /> CONTACT INFORMATION ` <br /> OWNER NAME: (yf/V4 Iti//t) s 7j4'J 1,, TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET /b 3 0 q J, 7 c17,2 eel. <br /> cnY B&--4.4..�1.-v e STATE* `j<„i A- ZIP p e 04 8 <br /> OWNER PHONE: - OWNER EMAIL: t t 1-1 ct q [L,,g ri 6...a s"..,..., e_5,1441.1. C,4,..1 <br /> 1 CONTRACTOR NAME: T. .P. <br /> i <br /> !CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> I <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> 'CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): \ <br /> PRIMARY CONTACT: D OWNER 0 CONTRACTOR :: ETHER(Please Specify) /i4Z.c 4-( ( T:.--C.`7" <br /> CONTACT NAME: t2.,o5r LrAr,MeS4f..4 CONTACT PHONE: C4-Lv-) 25-2,._" - 2 I J 3 <br /> -- j/' /tCLC..I-ti `Tics C7 V1Z,-- CONTACT EMAIL: r'-.SS Q., t(2C;,r- .f�_ -cr & .cairn <br /> BUILDING PERMIT APPLICATION <br /> 1 <br /> Existing Use of Building: S t ht-1 i-e /'e_ri al.e H c„ & - Contract Price of Work: $__ , <br /> a: <br /> Proposed Use of Building: T o`l6.....N H o <br /> e` Heat Source: OGas 0 Electric ❑Other _ <br /> Building Type: ❑SFR-Detached ''•.FR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: El New DAddition ❑Remodel DRepair ❑T.I. ❑Sign El Sprinkler ❑Demolition DChange of Use <br /> DESCRIPTION OF WORK: <br /> IB P it V V o.f >`r>_ '2 v/U UT T ca w lv t-t D '.S'' C o rt /e L t t , <br /> w/ !dam✓17 t v 1 D v 9{__ r ca M (-rJ I A. ( -C b-{ V N&g <br /> ASSOCIATED BUILDING PERMIT#(if applicable): G;' 4/ /4 l <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 #of 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 / Unit Heater ( 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 C Dishwasher Roof Drains <br /> Clothes Dryer Hookups Others I Clothes Washer Medical Gas <br /> / Range Hood I Water Heater Other: <br /> 3 Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Chemical or Water I 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 /> City of Everett Official Use Only , <br /> PERMIT# <br /> �. . -_ _ Gl 303 —P Z3 <br /> Owner/Aut orized Agent Signatu'e Date (Revised 9/23/2016) <br /> ,...J...,\ <br />