Laserfiche WebLink
EVERETT <br />WASHINGTON <br />_4PERMIT APPLICATIOI�' <br />BUILDING ,41 ECHANICAL I PLUMBING I SIGN �411INKLER I 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.00v I Www.everettwa.aov/permits <br />(Blue_olr_Blacik ink,Only,PliE`ase): , .., i k, PROJECT SITE aNF10RMq'TIOI, .._ ;:., .... a._.. • .'.. '., <br />PROJECT SITE ADDRESS: l G/N/fi- AVY. a/t-(9S201PROPERTY TAX #: 004�1 ZC� �30�3 <br />LEGAL for new construction: Short Platisubdivfsion 4h4/%r/c- 7ff4-t- A(Af Sfw,J Lot Nod_'-f 2-'{(attach copy of long legal description) <br />OWNER NAME: lever-rh- (51I-alto TENANT BUSINESS NAME (Commercial): �'-- <br />OWN ERMAILING ADDRESS: STREET <br />Crr ve STATE Lt> 19 ZIP <br />OWNER PHONE: <br />OWNER EMAIL: f3C.G <br />CONTRACTOR NAME: (� G?'` 2 <br />CONTRACTOR ADDRESS: STREET / / O 'y%_-%�9(:5 <br />cr Y iU�/� Gr STATE -,0 14--' zip 9 p tU T <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: +UE EEG- 5 �ff/DL�� to i1'I <br />CONTRACTOR LICENSE #(REQUIRED): "—` <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARYCONTACT: iP OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: ��� /( P� p �/ <br />/ <br />CONTACT PHONE: <br />CONTACT EMAIL: <br />Existing Use of Building: V6N­(C_"C— ("f}00 f Contract <br />Price of Work: $ --;17 b d 6 <br />Proposed Use of Building: PkIO47-6 &5,+&60 19h-kA—'f 1)C- <br />I Heat Source: ❑Gas ❑Electric ❑Other A/0 rLrG <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure <br />Type of Project: JENew ❑Addition ❑Remodel ' ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK:�P�� <br />ASSOCIATED BUILDING PERMIT # (if applicable):' <br />LVIECANICIILPRMiT_APPLICA�TION._:....r <br />_ . , RLiJMN1�iG,P1lRNIIT <br />+A1'PLIIriAT1aN <br />... ,.:: ;, <br />"tore <br />Fixture <br />CounfA/C <br />List of Fixtures <br />Fjou <br />count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />-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,baf) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Slnk Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatlor <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type I) <br />1 Hose Bibb <br />Urinal <br />Exhaust Hood (Type 11) <br />Water Heater <br />fnterceptor-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 <br />Other: <br />Medical Gas <br />lWater Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />Roof Drains <br />Water Heater <br />,, ;SPRINKLER C:SUPPRESSION„SYSTEMUM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />No. of Heads <br />Chemical Suppression System <br />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. 1 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 16.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PER�O� <br />(Revised 411512019) <br />