Laserfiche WebLink
PERMIT AEI'LICA`I`IOIJ <br /> DUILDIubkWECHANICAL I PLUMBING I SIGN" --:)RI60 KLER 1 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 /> ffLEGALfo, <br /> OT:��T -ADDRESS: �p�2 ©/'�/Yl�`s i/ PROPERTYTAX#: <br /> onstruction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> 01� ®Ct�llll(A`lf'99N <br /> OWNER NAME: _ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET II,, <br /> crrY �✓v T STATE KA, ZIP <br /> OWNER PHONE qq — go g6 OWNER EMAIL: <br /> CONTRACTOR NAME: Eb- C­120112L <br /> CONTRACTOR ADDRESS: STREET 21 Zo LC. <br /> CITY ESTATE WA ZIP 41 V-1 <br /> CONTRACTOR PHONE: (f25) 2-52- 3((L(- CONTRACTOR EMAIL: (° O- G (r►'Itc��`:CUtt�j <br /> CONTRACTOR LICENSE#(REQUIRED); CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (� <br /> PRIMARY CONTACT: ❑OWNERCONTRACTOR ❑'OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: L&Z- 0`7 2- <br /> CONTACT EMAIL: �� SSjYIGLi�'� •L�Z�i� <br /> :..BUILDING.PERMI`C,APPLIGA'1'1®Ye'! : -• ,• .. <br /> ev <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 C(Addition ❑Remodel epair ❑T.I. ❑Sign []Sprinkler ❑Demolition []Change of Use <br /> DESCRIPTION OF WORK: <br /> wr <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> 6V71 GI f Fd_r��ill�:�) 1Rii�iB It ' fr'P� ICT1bN �'bI�Y1�BrlElG P1 11!lla Y:�1' lel A 1 a®1�1 <br /> Type of Project: New _ Addn Alteration _REpair Type of Project: _New Addn Alteration _Repair <br /> #of List of Fixtures go List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump JToilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems 4 Unit Heater I Bathtub Urinal <br /> Gas Piping IBr ILava'LOry(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration IShower I Floor Drain <br /> Gas Fireplace Wood Stove I Kitchen Sink&Disposal I Grease Trap <br /> Gas Range Ducting I Dishwasher I Roof Drains <br /> Clothes Dryer Hookups Other: I Clothes Washer I Medical Gas <br /> Range Hood I Water Heater 10ther. <br /> Exhaust Fan I I Sink(Service/BarlMopletc. 10ther. <br /> ;fid®N4VM.M, . -..• <br /> Number of Heads <br /> ACKNOWLEDGEMENT 1 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 /> Huflding Official before being authorized under any circumstance.I am the owner,ori 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 98.27 RCW and 296.200A WAC. <br /> City of Everett Oficial Use Only <br /> PERMIT <br /> /20/2096) <br /> Owner/Authorized Agent Signa ure Date (Revised 5 <br />