Laserfiche WebLink
101477PERMIT APPLICATION <br /> BUILDINW MECHANICAL I PLUMBING I SIGN ! -INKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> . $. PROJECT SITE INFORMATION, . <br /> Pt <br /> S_I AD gliEg <br /> ,arNr Sic PROPERTY TAX#:D105‘I tit,1 h: `jotz,3 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> r <br /> CONTACT INFORMATION .' <br /> OWNER NAME:Eq'(_.(e.4 V\OL %•ry `tiovs '. j TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET'•b F, \ 5I1 <br /> cnY t-W-CCA STATE W C;L ZIP990((%.\�- <br /> `� <br /> OWNER PHONE: OWNER EMAIL: � <br /> CONTRACTOR NAME '' Cl..‘4‘.;... ‘11•,. <br /> CJS <br /> CONTRACTOR ADDRESS: STREET 1:`2,1 )01-F.: W \\ <br /> rr�� <br /> CITY� (x r \ STATE l \\ ZIP I J� 1 ar <br /> CONTRACTOR PHONE:LG50M-c LI CONTRACTOR EMAIL: (IS e�O \\\`(\4�-,w\U�©\`Cr)et\.7 <br /> CONTRACTOR LICENSE#(REQUIRED): Cot 1- n•--CP-14 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):t5g3c o <br /> PRIMARY CONTACT: ❑OWNER I eONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 1.4.. , -2,\,_s3q LI <br /> - \(\`C\ k.\\\Q' CONTACT EMAIL: `c-- 0= \-st\ `‘n (q.\4 QM>0U\, <br /> ": BUILDING PERMIT APPLICATION :- <br /> Existing Use of Building: Wkt.0,\V;--N-:ettA j Contract Price of Work:$ 7)��•" <br /> Proposed Use of Building: t Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex MAllulti-Family-#of Units: 4 ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel E2epair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> D SCRIPTION OF WORK: , *,.f . 0. _ c `�) t.- : ..4". <br /> 1t l� ` ' - 4 '— .9 i .,-- <br /> II'. <br /> ��„"{oVCc' mer .e..l sA-kx\ \ \c ec S" . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <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 #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-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 /> SPRINKLER/:,SUPPRESS ION 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 iltthrg Official before being authorized under any circumstance.tam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> a d I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> e�] City of Everett Official Use Only <br /> `� c ., ' 1: `9-1� PERMIT ti,..)I fA 1 'C10 <br /> •^,u1 uthorized gent i a e Date (Revised 10 12/2015) s <br />