Laserfiche WebLink
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 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: O` PROPERTY 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): ti I "A <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Anderson Mech Htq & Q1q Inc <br /> CONTRACTOR ADDRESS: STREET 8708 Arlington Heights Rd <br /> CITY Arlington STATE WA ZIP 98223 <br /> CONTRACTOR PHONE: 425-422-0160 1CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): AN D E R M H837C P CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) j <br /> CONTACT NAME: CONTACT PHONE: 4255-422-0160 <br /> Jesse Anderson CONTACT EMAIL: <br /> i <br /> BUILDING PERMIT APPLICATION I <br /> Existing Use of Building: Contract Price of Work:$ f <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial { <br /> Type of Project: ❑New ❑Addition ❑Remodel []Repair ❑T.I. ❑Sin ❑S rinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> r <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> k <br /> MECHANICALPERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> t <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 g <br /> 3 <br /> A/C—Air Handling Units I 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 t <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM- <br /> Number of Heads I <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.1 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 /> 2 a 1 v -10-- Cliq <br /> 7r1Auth&r—iz-e—d eAgent ignature Date (Revised 10112J2015) I <br />