Laserfiche WebLink
47677PERMIT APPLICATIOI— <br /> BUILDIN u i as►IECHANICAL/ PLUMBING I SIGN I IIIRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> a-T(3 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> ..'.: •;: ,. PROJECT SITE::;INFORMATION. ... <br /> \P OJ CT SITE ADDRgSS: PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> ;CONTACT INFORMATION 1` <br /> OWNER NAME:E\L( t\Ot.►Svr k -\-�Qc-N X TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET.•+(? CI \ `",tl <br /> cnv t.vt? . STATE W(_ ZIP990(n-l`^ I l <br /> OWNER PHONE: OWNER EMAIL: `�� <br /> CONTRACTOR NAME: 4 C,\ ' GJ� <br /> CONTRACTOR ADDRESS: STREET tD�)c. (J( \ <br /> CITY< et NC ` STATE k...,„1.3� ZIP 9lagRi-► <br /> CONTRACTOR PHONE:14g"p( "_t L1 CONTRACTOR EMAIL: CIS r.f ‘,jt\A,( . C* ,Q`+ci ciY\., <br /> CONTRACTOR LICENSE#(REQUIRED): Cab\-W:6.1. 9'2jL CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):IZZe SCK0 <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 1-1,'pb-9,\�--Cc 5 L_) <br /> - .\C\‘C W L\\o CANS CONTACT EMAIL: •c--.-. P 'pr=V\,h� ), cam,\, �,0 <br /> • BUILDING;PERMIT APPLICATION : . <br /> Existing Use of Building: YVw,\ --00-1,A l Contract Price of Work:$ -7)5M•` <br /> Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex 'Multi-Family-#of Units: 4 OCommercial ❑Industrial <br /> Type of Project: DNew DAddition ❑Remodel eizepair OT.I. ❑Sign ❑Sprinkler ❑Demolition OChange of Use <br /> D SCRIPTION OF WORK: 0t,.•.! , r _ i 4:‘,..- - 4 • ri •• <br /> r Oillq, ' ' ce Mer \ \(x4 ec S" A) <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT�APPLICATION,: <br /> , •; . `- _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 #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> AIC-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration 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 /> :. RINKLER/:;SUPPRESSION SYSTEM`. <br /> Number 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 /> 8 il6Ing Official before being authorized under any circumstance.I am the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> a d f co ply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> `1 • '� �• � PERMIT# 61(PO <br /> I /+t /J,of ,/ --�: • C . I V t,/Vl <br /> • •uiv •uthorized •gent I a e Date (Revised 10/12/2015) <br /> ‘,1? , <br />