Laserfiche WebLink
03/21/2016 MON 15: 21 FAX 4252521666 CM Heating 0002/003 <br /> PERMIT APPLICATIC <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)426-257-8610 i FAX 425-267-8867 1(E)everettepsgevereltwa.goV I wwmeverettwa.gov/permits <br /> •PRO'JEC,T SITE INFORMATION . - <br /> PROjECT SITE;ADDRESS: PROPERTY TAX M. <br /> Tr <br /> LEGAL for new constructlon: ShortPlatfsubdlvlslom Lot No. (attach copy of long legal doecrlptlon) <br /> '..Ju ,.i`4'.i,i•��r'.r'<Jfr,"(,,�t'�`' .3r;'� �i; 'i' .r.• <br /> 'CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME=(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CIN STATE ZIP I <br /> OWNER PHONE: 31414 G1 I OWNER EMAIL: <br /> CONTRACTOR NAME; y N <br /> CONTRACTOR ADDRESS: STREET <br /> GITY STATE �/V ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRQD): <br /> PRIMARY CONTACT; ❑ OWNER 14CONTRACTOR ❑ OTHER (Please Specify) <br /> CO TACT NAME: �'�y� , ( CONTACT PHONE: �1 <br /> `yup 0 I IV � CONTACT EMAIL: <br /> ,sit,l.t.�y r?,`kCi u�,.}, Fl,.hX,.l l,y p ,••, ,.,F .7;.�J `I'};;b.i <br /> P .•.; <br /> '� ., �:c.v, ",t �. ,;;y;.• �,.1 i,�;,u: •� :y�,�; �UrLDIwhG��ERMIT,'APPI:ICAT�O1� <br /> Existing Use of Bulldin Contract Price of Work: $ <br /> Proposed Use of Building: Heat Source: AGas ❑Electric ❑other <br /> Building Type: ©SFR-Qetached FR-Attached ❑Du lex []Multi-Famll -#of Units: OCommBrcial alndustrial <br /> Type of pro oct:Aew AAddItIon ❑Remodel ❑Repalr ❑T.I. ❑SI n _[]Sprinkler ❑Demolltion OChan e of Use <br /> DESCRIPTION yOF WORK: <br /> ASSOCIATED BUILDING PERMIT# If applluablu : <br /> �kl;cM ' ' .! `s; �?f Ate. hC'4'1r�.Qw'' PL[yMBING.P1=RM.iT'b'.,PGfi,CktION <br /> Type of ProJoct: Now Addn _Alteration _Repair Type of Protect: _New _Addn _Alteration —Repair <br /> Fixtures List of Fixtures Fl N of List of Flxturos #of List of Fixtures #of Llsi of Flxturas <br /> Fixtures Flxturas <br /> A/C–Alr Handlln Units Heat Pump Toilet Backflow Preventer inside Bid <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boller Lavatory Wash Basin Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood 5tovo Kitchen$Ink& Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hooke s Other; Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink Servlce/Bar/Mo lett. Other: <br /> Number of Heada <br /> ACKNOWLEDQEMENT.'I have revlewed this application and confirm the infprmetlon contained herein is true end correct. Work done pursuant to this permit must comply with <br /> curreni federal,state,end local law. Tha granting of a pormlt only authorizas approved work and no devlatlons therefrom,Devistlons must firs(be authorized in writing from fho <br /> Building Official beruru being euthwized under any circumstance.I am the owner, or I am authorized Dy the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 16.27 RCW and 206-200A WAC, <br /> City of Evaratt Official Use only <br /> L�S,(-6ao. PERMIT ft coo <br /> lilo�� <br /> Owner/Authorized Agent Ignetu a Dat (Rev sad 1 1 20f 5W� <br /> .� <br />