Laserfiche WebLink
(PERMIT APPLICAI If IN <br /> BUILDI I MECHANICAL]PLUMBING I SIG=ZSPRINKLERI 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 l www.everettwa.gov/permits <br /> (�9s��,�rr 1�9��1�"lualls,®qv)1}�&Pile�s�) " l>�L�®JII��'H'SB'H°�•11Mtg�l�6di�a'I��®&EI " <br /> PROJECT SITE ADDRESS: '' PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach dopy of long legal description) <br /> d®R3_Y.AC`iT 11i41P0RMAT ION <br /> OWNER NAME: ( f{ d TENANT NAME(if Commercial): <br /> OWNER MAILING ADDRESS: STREET �f(J C <br /> CITY STATE zip <br /> OWNER PHONE:(i�- ) f5 — "!)(a I OWNER EMAiL: Ali <br /> CONTRACTOR NAME: —'jr % CAe <br /> CONTRACTOR ADDRESS: STREET ,t}- 6 <br /> CiTY ^(J , STATE ZIP - � <br /> CONTRACTOR PHONEZS Z`-�Z �/ CONTRACTOR EMAIL: ��vt � �,�yJ't4[,G:O)t't <br /> CONTRACTOR LICENSE#(REQUIRED): — r zr�T CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: O OWNER CONTRACTOR O OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (`'fZS --0 7 Z-7- <br /> CONTACT <br /> Z <br /> CONTACT EMAIL: <br /> _.BUILDING.PER MIT:APPLIGATION <br /> Existing Use of Building: Contract Price of Work:$ <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: ONew OAddition ❑Remodel Repair OT.I, ❑Sign~, OSprinkler ❑Demolition ClChange of Use <br /> DESCRIPTION OF WORK: j"AKY <br /> r <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MEGHANL_ICAL.F)91 V 11"APP iCAT-IQN PLUMBING PERMIT.:APPLICATiiON <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 /> A1C—Air Handling Units Heat Pump Toilet Backffow 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 IDucting I Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood lWater Heater Other. <br /> Exhaust Fan I Sink(Service/Bar/Mop/etc.) Other: <br /> S1PRdUlit!LER.I SUPP ES SII®N.SYS'Y'1=M., . :.._ <br /> Number of Heads <br /> ACKNOWLEDGEMENT,t 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/ocallaw. 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 I am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 98.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT <br /> IM [ loll <br /> Owner/Authorized Agent Signa ure Date (Revised 5/20/2096) <br />