Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDINr CHANICAL / PLUMBING /SIGN / JNKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 23eg Ggsiiuv P-A EV4-R-6- r v AA 962oy PROPERTY TAX#:2U64//`/oo 2 v i c,00 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: I CA,1V aLMLDE,69-S r 60lVe%q(T0,L SVP T) ENANT NAME(If Commercial):,J13C SU PpLY rG, /Ale <br /> OWNER MAILING ADDRESS: STREET 0,4JE AE3G PPoZy.w.6 Y <br /> . . CITY -i L(30'/ STATE VVX - zip 535 I <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME; A/0,27NWE,S'T <br /> CONTRACTOR ADDRESS: STREET "72-'7 S 5'644 S i <br /> CITY SE19 7-7/- C STATE ZIP <br /> CONTRACTOR PHONE: �2cj 6"2-3 3iao CONTRACTOR EMAIL: i�S�en f �e-Alnklor A bt/C&I. cU <br /> CONTRACTOR LICENSE#(REQUIRED): fi617-jY/ --,96 10 E CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):Od%—l(0)-7 <br /> PRIMARY CONTACT: D OWNER IA CONTRACTOR []OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206 6,�,3 30oo <br /> Alri,SO4n 14cisan CONTACT EMAIL: 4&L 4e-<ULrirarCO— <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Lu n6(R L 0 1(2 3uk..o,Nlr MV7r-e.4" Contract Price of Work: $ 2-06.16 <br /> o° <br /> i <br /> Proposed Use of Building:Lvmb(G 07ilNZ j3ui44At, MA74SteS Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached []Duplex ❑Multi-Family-#of Units: Ncornmercial []Industrial <br /> Type of Project: []New []Addition []Remodel []Repair DT.I. DQSign []Sprinkler []Demolition []Change of Use <br /> DESCRIPTION OFWORK: INiTn, <p2) NON it`um�vg7E0 12E✓ GH'ANA/EL L(- 7E2 CCt �vl <br /> .-A-Wov, ms-r4g.r_ 3) i1/i),V1 OUAL <br /> tumi,vATEo "SuAAI,Y to. v( <br /> 5/0 n/4 , , 1 ?A'UF— �NS�/1�-L ��r) s�F l�uv-�r_t�.I,rn g7Eq y„R�•�- P1�1JC�—S 12 , <br /> 6u*s(2' )at SULA-7A1,u •a� t?oo Fi,vG <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 <br /> Fixtures List of Fixtures <br /> 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 lGrease 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 J=1 — I <br /> ACKNOWLEDGEMENT:l 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 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PER IT# <br /> �•�o. SI�Q� <br /> Ow orized re Date (Revised 5/20/2016) <br />