Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING; i�iECHANICAL / PLUMBING /SIGN /Ji' EtINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 4477 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 /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:_� ;- PROPERTY TAX#: r <br /> 1Z �3Qi > C>n J ' / v3 o� l p <br /> LEGAL for new construction: Short Plattsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET S3 Cr ✓(— t' 7f� PL �} 1 <br /> CITY \(-�!U('� STATE /U. ZIP �(,L7p L� 3 G! <br /> OWNER PHONE: �LS. (�d� Iq ` OWNER EMAIL: <br /> CONTRACTOR NAME: N acv 4 t c <br /> CONTRACTOR ADDRESS: STREET �j 3 J' I f J L <br /> CnY l r<</t.r G� STATE (1)G ZIP <br /> CONTRACTOR PHONE: 5 6�J''.' �i CONTRACTOR EMAIL: lw.a <br /> CONTRACTOR LICENSE#(REQUIRED): T1 NPL 70113! CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: a OWNER E&CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: i 1 S—l✓ - Lqx C <br /> CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: n.,c,!4 Contract Price of Work:$ <br /> Proposed Use of Building: Gc Uri <. Heat Source: ❑Gas QElectric []Other <br /> Building Type: 25SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Family-#of Units: ❑Commercial El Industrial <br /> Type of Project: ❑New ❑Addition ®,Remodel ❑Repair ❑T.I. ❑Sign []Sprinkler ❑Demolition ❑Chan a of Use <br /> DESCRIPTION OF WORK: �J� �7lc�c v ii- ixcz If z,.v W�.-arc- (c:t-/,c tN TU r~!, <br /> T t,t o �a 1113 at 1`�- ,��lK..:r, �res -f_ �z l o<: fie L oc�n�l,-� 4L Not ��..ra- tG �C , U(-'f��1 t� e x,5-IL."'q <br /> Fu,tl 13,,t1, w <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 List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump IToilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater 2- Bathtub Urinal <br /> Gas Piping Boiler L 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 i Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: ( Clothes Washer Medical Gas <br /> I Range Hood I Water Heater Other: <br /> j Exhaust Fan Sink(Service/Bar/Mo /etc.) Other: <br /> SPRINKLER/SUPPRESSION 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 /> Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the o caner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors La w 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> OH <br /> Owner/Author' ed Agent Signature Date (Revised 10/12/2015) f L <br /> a J <br />