Laserfiche WebLink
PERMIT.APPLICATION <br /> BUILDIP16 MECHANICAL I PLUMBING I SIGNRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVIW <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> EPT'-;k1TTIE <br /> PROJECTS] ADDIREM PROPERTY TAX 4: <br /> V'40-1 k �� 5 <br /> r2-c 1 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> I. <br /> TAPTIINF A .T. <br /> 777 <br /> OWNER NAME: av a TENANT NAME(if Commercial); <br /> 'J <br /> OWNER MAILING ADDRESS: STREET 10ic-7 baAo..j Av STATELY - ZIP <br /> ony <br /> OWNER PHONE: 42-S*-2-Pie- OWNER EMAIL: 17 \UZIQV-Ovl 5?)kod00�u' I.cc n, <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EM.AIL: <br /> CONTRACTOR LICENSE#(REQUIRED): ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: V OWNER 11 CONTRACTOR El OTHER(Please Specify) <br /> CONTACT NAME. CONTACT PHONE: If L#57-7-9,41 <br /> L lyc-rLvCONTACT EMAIL: bk'xe�koro ii 5-at -c cp�Nvh't" <br /> j� <br /> BUILDING POW K <br /> C 4 <br /> Existing Use of Building:15�itujl re Contract Price of Work: <br /> Proposed Use of Building: YN• -PA 11 r?S device --leat Source: OGas DElectric ElOthe <br /> Building Type: %SFR-Detached EISFR-Attached ODuplex E]Multi-Family-#of Units..ElCommercial ElIndustrial <br /> Type of Project: F1 New MAddifmn ORernodel ORepair 11T.I. OSign ElSprinkler ElDernolition OChange of Use <br /> 'e <br /> jiT—k'j n C;1111 - %?% W :''i I <br /> , -P-%,111-4.,,l i. <br /> 1W Lk&e k*%zer in 1�)I , <br /> DESCRIPTION OF WORK: .4 ns V16.' 6.�" <br /> LO '��Ctcs A6.t- A;J11 nj ('T'S 5 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> tATI <br /> MECHANICAL t ON <br /> .Type of Project: -New Addn —Repair Type of Project: New --Addn -Alteration _Repair <br /> #of— #of of List of Fixtures --To—f List of Fixtures <br /> Fixtures List of Fixtures Fixtures List of Fixtures Fixtures Toilet Fixtures Backflow Preventer(Inside Bldg) <br /> A/C—Air Handling Units Heat Pump — -/ Urinal <br /> Forced Air Systems Unit Heater— Bathtub <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 /> Water Heater Other: <br /> Range Hood <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other., <br /> lNumber 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!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 16.27 RCW and 296.200A WAC. City of Everett official Use Only <br /> /3 PERMIT# <br /> OwnerlAuthbrized Agent Signature Date (Revised 1011212015) <br />