Laserfiche WebLink
02?01I201 10 : 22 :1G71 P. 001;'002 <br /> PERMIT APPLICATION <br /> 13UILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREI=T,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-2578857 1(E)everetteps@everettwa,cgov vvww.everetlwa.gov/permits <br /> " :, i;pROJ�CT,SITI` IiVFORMATiON , <br /> PROJECT SITE AppRI=SS; PROPERTY TAX#: <br /> 3 0 l Af.0Ar6AW <br /> LEGAL for Ilew Construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTA4T:INFOP.WATiON', <br /> OWNER NAME: Q��.(� C �' l .t.(/,�� TENANT NAME(If Commercial): <br /> OWNER!NAILING ADDRESS: sT ger R b 80)C 1,2.3 <br /> CITY IP �a <br /> OWNER PHONE: Zf B 3// OWNER EMAiL: <br /> CONTRACTOR NAME: !G ✓�✓9-L Jj0�/(s <br /> CONTRACTOR ADDRESS: sTRFE Dl 4 � �Ll <br /> CITY _ sTATF ZIP <br /> CONTRACTOR PHONE: t' CONTRACTOR EMAIL: <br /> CONTRACTOR LiCENS!" CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):CJS/( S4?,7 <br /> PRIMARY CONTACT: ❑OWNER ,{CONTRACTOR 0 OTHER(Please Specify) #*)APL d _yL <br /> CONTACT NAME: CONTACT PHONE: i 3 Z 2.Z <br /> CONTACT EMAIL: <br /> l3.r1�h1a#NI3`0.EIlk $II APpl; ¢ATtQN <br /> Existing Use of Buildin Contract Price of Work:$ a O O <br /> Proposed Use of Building: lHeat Source; as electric F�fOther <br /> Building Type.,__❑SFR-Detached ❑SFR-Attached MDu lex ❑Multi-Famil 4 of Units' QCommercial ❑Industrial <br /> T of Project: UNew ❑Addition MRemodel ❑Ra air ❑T.I. FISi n CI5 rinklar MiDemolition ©Chan e of Use <br /> DESCRIPTION OF WORK: <br /> AM X47' 1' v Aq <br /> ASSOCIATED lBUILp1NG PERMIT# if applicable): <br /> MECHANICAI ..PERMIT gRPLICATIO PLUMBING PERMIT APPLICATION <br /> Type of Project: 4:,L-Kew _ Addn _Alteration �Rapalr Type of Project: _New _--,Adds _Alteration —Repair <br /> Fixtures List of Fixtures of Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures <br /> A/C--Air Handling units Heat Pump Toilet Fackfiow Preventer(Inside Bldq) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) 0rjni<jnQ Fountain <br /> Water Heater Refrl eration Shower Floor Drain <br /> Gas Fireplace 1WOod Stove Kitchen Sink& Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes D er Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Hsatsr Other: <br /> Exhaust Fan Sink(Service/Far/Mop/etc.) Other. <br /> %PRINKLI-RI/suPPRr:ssio.N 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 roust comply with <br /> current tederal,state,and local law, The granting of a permit ooty authorizes approved work and no davletionz therefrom.Deviations must first be authorized in writing from the <br /> gold/ng Official before being authorized undor any circumstance.I am the owner,or I am authorized by the owner of this property to ponorm tho work for which application is made. <br /> and I comply WiA J&state Contractors LaW 18.27 RCW and 296,200A WAC. <br /> City ofEvorett ONiclal Use Only <br /> Signaturo Da <br /> t/Au orized tt t VV L~ lvJ�vl <br /> (Revised <br />