Laserfiche WebLink
41ren. PERMIT APPLIC <br /> BUILDINQI"ECHANICAL/ PLUMBING / SIGN I "I RINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT S <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:• L 1 ,J Z -'vel r hROPERwTYY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: IN J)rfix"115 7 <br /> CONTRACTOR ADDRESS: STREET I�j c 7 / 4(A. IT 4 <br /> � ACITY y YI h U/ o..' rrV� STATE g ep. Gp ZIP <br /> CONTRACTOR PHONE: yli--?f r-076 " CONTRACTOR EMAIL: td iAt e5 e-or -r tette, ti6l� <br /> CONTRACTOR LICENSE#(REQUIRED): Inv}-(II(i.L L ,26 CJ CITY OF EVERETT BUSINESS LICEN E#(REQUIRED):4J 1',(1;:, <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 7 ---2-7 f-7 <br /> 7) 7/J <br /> CONTACT EMAIL: '‘44,1--,--- ✓.1 ,,s.1, ;, iJ . <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $ --7 r Co U <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: ommercial ❑Industrial <br /> Type of Project: ONew ❑Addition DRemodel DRepair DT.I. ❑Sign DSprinkler ODemolition ❑Change of Use <br /> DESCRIPTION OF WORK: )/l ta- /1 171140 4 & ' <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 /> NC-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 /> PERMIT# <br /> Owner/Authorized Agent Signature I Date (Revised 10/12/2015) <br /> v/2 <br />