Laserfiche WebLink
4:47.7 PERMIT APPLICATION <br /> BUILDING / MECHANICAL / PLUMBING / SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 332-Co FM t E_ Ave.K,OE PROPERTY TAX#ax3iQ71?Q l BOO <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION _ <br /> OWNER NAME: 6" cteg Not:was UJ TENANT NAME(If Commercial): Woo AkoriSTses <br /> OWNER MAILING ADDRESS: STREET SIO et MC iDOC1( ,4LL AVM. <br /> CITY Y,VI�ESTATE WA- ZIP 6E267 <br /> OWNER PHONE: OWNER EMAIL: brOdwloKS-kr Cw yahoo.Com <br /> CONTRACTOR NAME: ---CI.D <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: -, -) <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(RE IRED): <br /> PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR PPOTHER(Please Specify) ASH I TELT <br /> CONTACT NAME: /1/11/X-6 .x}✓� CONTACT PHONE: 42.6---zs, - 7 %g <br /> CONTACT EMAIL:0 CO c vt1. , cow <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: S- 1 Contract Price of Work:$ 1RCC5 4., <br /> Proposed Use of Building: S-1 Heat Source: 116s ❑ElectricLL❑Other <br /> 4xt.: <br /> Building Type: USER-Detached USER-Attached ❑Duplex ❑Multi-Family-#of Units: ommercial ❑Industrial <br /> Type of Project: ❑New eikddition ❑Remodel El Repair ❑T.l. ❑Sign,t ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> d ?/ 00 ADDi.1-I01( TO 44 EXIs-l- 6 W4 --OUS5U4L-Di i . <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/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 /> 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 /> r PERZ# <br /> # <br /> `' 2. Z. / < L©Pt -- () <br /> / 0\ 'er/Authorized Agent Signature Date (Revised 5/20/2016) <br />