Laserfiche WebLink
_ PERMIT"APPLICATION <br /> 7 HUII�.DW MECHANICAL I PLUMBING I SIG PRINKLER I DEMOLI1-ION <br /> CITY OF EVERETT PERMIT SER <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 /> (Blue or Black leak ®"ly Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:(3 �, , Sk 'J � PROPERTY TAX#: 00437: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: „�C �� vp'1(\, TENANT NAME([f Commercial): <br /> OWNER MAILING ADDRESS: STREET 38-t-ln AV v­z AA <br /> CITY STATE ZIP J� <br /> OWNER PHONEC-ZO6JOWNER EMAIL: q p” I <br /> CONTRACTOR NAMF 0 U,3V\eX— <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: OWNER ❑ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ZC�(j 0 ZU� <br /> �V C1(/1 a ` P�J 0(/L CONTACT EMAIL: JAAa VW :�p I ��( � C�a <br /> BUILDING.PERMIT.APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ <br /> Proposed Use of Building: Heat Source: []Gas lectric ❑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. ❑Sign []Sprinkler ❑Demolition []Change of Use <br /> DESCRIPTION OF WORK: 12e-o�0e coo <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MEC14ANICAL 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 /> 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.) Other: <br /> SPRINKLER/SVPPRESSION 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 /> Buildin 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 o ly with the Sta Contractors Law 98.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> A 01 <br /> PERMIT# <br /> Owner Aurized Agent gnatur Date (Revised 5/20/2096) <br />