Laserfiche WebLink
PERMIT APPLICATION <br /> .�,.y/ BUILDING CHANICAL / PLUMBING / SIGN I..yl IJINKLER/ DEMOLITION <br /> WV <br /> MiGCITY 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 /> PROJECT SiTE INFORMATION <br /> PROJECT SITE ADDRESS: 2130 <br /> — IOoTSt s w PROPERTY TAX#: d 09322 66 b OLE C)C <br /> LEGAL for new construction: Short Plat/subdivision__._ _Lot No. (attach copy of long legal description) <br /> ^� <br /> CONTACT INFORMATION <br /> OWNER NAME: Ca." Daj.c-- TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET S C.c'nL <br /> CITY STATE ZIP <br /> OWNER PHONE; OWNER EMAIL: <br /> CONTRACTOR NAME: Ed m ones .P I vt.p.io I-� /t„y L L-C--, r <br /> CONTRACTOR ADDRESS: STREET [4:,gz . �+- - '- v.], t� <br /> CITYL- <br /> -Y`titn k p O C7, STATE ti\JA ZIP (g O <br /> CONTRACTOR PHONE: .2-0(0, 920 , ?D©0 p CONTRACTOR EMAIL: '§ ecce `t eed{�0ad pi(,(,fist %rtit JCC , (.06* <br /> CONTRACTOR LICENSE#(REQUIRED): EI(110v..1 P 4-(3 9 ‘4 0 i CITY OF EVERETT BUSINESS LICENSE#t(REQUIRED):J4Z. Lf <br /> PRIMARY CONTACT: 0 OWNER ©CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ,,���,,,,ii ,,(, . 9 Z.© . g O U i� <br /> t- ' j p cod I c CONTACT EMAIL: �t (t c,7c-- C(ivnJ ruis,p ft(t /i i 1 1[c .c0 ryk <br /> G <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $ <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached DSFR-Attached 0 Duplex ❑Multi-Family-#of Units: DCommercial CD Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel DRepair DT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <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 X Repair <br /> Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #of List of Fixtures <br /> 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.) C Other: f L p 4.t V i c,..4. be ocri <br /> KJufcr Irti(:. .01d Iorbker. <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Vent I it amt[2 t1 <br /> [Number of Heads -tree <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.lam the owner,ort 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 /> Cltie,t___,4:,___, PERMIT# p) x 3 06, <br /> ,4 0144/9e4,, -24 i 71Z2)16) <br /> Owner/Authorized Agent Signature ✓T Date (Revised 10/12/2015) <br />