Laserfiche WebLink
09/24/2016 TUE 13: 09 FAX 425 252 1666 CM Heating 0002/002 <br /> PERMIT APPLICATIOP <br /> BUILDING I MECHANICAL I PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8010 i FAX 425-257-8857 1(E)everettepsQeverettwa.Uov www.evereitwe.gov/permits <br /> B#rW ,,Ar:4#ak;lri4�` ►i#y Pl..ea`s P# Je¢ $.IT,� IN�.QMATION <br /> PROJECT SITE ADDRESS: PROPERTY TAX#; <br /> LEGAL for new constructlon: Short PlaUsubdlvlslon Lot No. _ (attach copy of long legal description) <br /> OWNER NAME: ( L06_1 <br /> TENANT NAME If Commercial): <br /> OWNER MAILING ADDRESS. STREET C <br /> c17Y STATE / ZIP <br /> OWNER PHONE: c�► OWNER EMAIL: <br /> CONTRACTOR NAME; t <br /> CONTRACTOR ADDRESS; STREET VI 'Fo ( <br /> CITY 6TATE ZIP <br /> CONTRACTOR PHONE. CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED)CM �7'� n CITY OF EVERETT BUSINESS LICENSE#(REQUIRED <br /> PRIMARY CONTACT: ❑OWNER KCONTRACTOR ❑ OTHER(Please 9peclfy) <br /> CONTACT NAME: r CONTACT PHONE; <br /> CONTACT EMAIL;!htcbTi rK) <br /> Existing Use of Building, Contract Price of Work: <br /> Pro aced Use of Building: Heat Source: as 41 ❑Electric ❑Other <br /> Bulldln Type: SFR-Datachod ❑SFR-Attached ❑Du lex [],Mull[-Family-#of Units: ❑Commerclal ❑Industrial <br /> Type of Project: ❑New E]Addltlon EJRemodel ❑Re air OT.I. ❑SI n []Sprinkler QDemolitlon ❑Chan e of Use <br /> DESC�RIIP,TI,,O,N OF WORK; <br /> it <br /> :Jjjj <br /> -"/." qaS; [f�-[b [f <br /> -r4 ,,S P.(� 4 ips <br /> ASSOCIATGJD BUILDING PERMIT# if applicable): (� <br /> �,.. a,P , I, perp#cAX;)OR <br /> Type?4UProtect; _New _ Addn _Alteration _Ropelr Type of Project: New _Addn Alteration _Repair <br /> °f List of F7xturss #°f List of Fixtures #of List of Fixtures o! Llst of Fixtures <br /> _;4o <br /> a Fixtures Fixtures Fixtures <br /> A/C-Air Handling Unite Heat Pump Toilet Backflow Preventer Inside Bld <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Bailer Lavatory Wash Basin Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Draln <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range DuctIng Dishwasher Roof Drains <br /> Clothes Dryer Hooku a Other; Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink (Service/Bar/Mop/etc. Other: <br /> umber of Hea s <br /> ACKNOWLEDGEMENT.'i have revlewed this application and confirm the information contained herein Is true and correct Work done pursuant to this permit must Comply Min <br /> current federal,estate, 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 offic)at before being authorized under any circumstance.I om the owner,or I am etlfhorized by the owner of this properly to perform the work for which application Is made, <br /> and I comply wllh the State Coniractors t-ew 98.27 RCW and 296.200A WAC. <br /> City of Everett Official U9e only <br /> I PM'�'U9 <br /> O <br /> Owner/Authorized Agent Slen tura Date (Revsad 612012016) <br />