Laserfiche WebLink
r <br /> PERMIT APPLICATION <br /> ,.... <br /> M BUILDING J MECHANICAL I PLUMBING 1 SIGN I SPRINKLER I DEMOLIT'IoN <br /> > r••;Jas CITY OF EVERETT PERMIT SERVICES <br /> vz, f._ 'L),--7. 1./' 3200 CEDAR STREET,EVERETT,WA 98201 <br /> -- (P)425-257-8810 i FAX 425-257-8857 1(E)everetteps©everettvia.gov I www.everettwa.govlpem1its <br /> - <br /> (�,,�,a��.;®t��9i4ii'I[sa1�.�anlf3�0.11,411 .. , 1!�?G�® � 9 <br /> ���y',�$Q'�'I�• k�tli'O1E�61ff�'f'I(O�l ' <br /> PROJECT SITE ADDRESS: //b2_. Thi. 416 KE 12 PROPERTY TAX#: <br /> Lot No. , (attach copy of long legal description) <br /> LEGAL.for new construction: Shod Plat/subdivision <br /> OWNER NAME: "-(Z�j L.1- TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET l (( 1ZLA-4-- , kvG' <br /> CITY 'L-�/ C l STATE 1.421.A Z11' i a Z <br /> OWNER PHONE: .,_..... ... .!OWNER EMAIL:.... . <br /> CONTRACTOR NAME: ( t7 ? t 5 /—�c A6 <br /> CONTRACTOR ADDRESS: STREET 2-1,20 PA-CL Le•- <br /> cnY 6.)(-n <br /> STATE l OPI. zip 4 V20 t <br /> CONTRACTOR PHONE: ('-l2$) '252-- 5(v-- ONTRAGTOR EMAIL: ( -Q•-.6`�f*riel0✓G<-` pr,,/ �✓ <br /> UIRED: CITY OF EVERETT BUSINESS LICENSE rf(REQUIRED): C2 3 <br /> GTDR LICENSE#(REQ } '�-v�tZ�s� "" � <br /> CONTRA <br /> PRIMARY CONTACT: °OWNER ,4CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (1,.25•) 5-64—O 7Z.'- <br /> Vl1(•.) cruel CONTACT EMAIL_ vt...40S/YIGf.,1a.•61, 14— — — <br /> :. ..,:; .. ;D1UILDINC .I?ERM1T.ARPLI AI f®t�1' _- — — — -'•_,. <br /> - <br /> Existing Use of Building: Contract Price of Work:$ __�i1.t • <br /> - ProposedUseofBuilding: Heat Source: -as °Electric °Other <br /> Building Type: 10%-FR-Detached °SFR Attached ElDuplex °Multi-Family-#of Units: <br /> °Commercial °lndustda[. <br /> Type of Project: °New °Addifion °Remodel El Repair T.I.Y °Sign °Sprinkler °Demolition °Change of Use <br /> • <br /> DESCRIPTION OF WORK: n"-A pe, QirL 6. - Eckas-NA-E , <br /> • <br /> ASSOCIATED BUILDING PERMIT#(if applicable): _ __ — <br /> .•tVIOOI4Af pc&i::0,00Mait",�P ? [ <br /> � 0A•II'''''3' • - '••. :. P.L.D, I011a6 [ I tt':' o croxi icto ... • . <br /> s;::...-'1. ---- of Project:•___,New Addn Aiferatlon __.Repair <br /> Type of Project: New Addn Alteration—.Repair TypeI �o� <br /> i _ #of List of Fixtures <br /> ##of List of.Fixtures List of Fixtures FixturesF ur es List ofFiYtures Fixtures <br /> Fixtures 1 Toilet Backflow Preventer(Inside Bldg) <br /> NO—Air Handling Units Heat Pump Bathtub Urinal <br /> L Forced Air Systems 1 Unit Heater <br /> Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Gas Piping I • <br /> Water Heater { Refrigeration Shower Floor Drain <br /> Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Fireplace <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Other: <br /> Clothes Dryer Hookups Clothes Washer Medical GasWater Heater Other: <br /> Range Hood I <br /> Exhaust FanSink(Service/Bar/Mop/etc.)efc.} Other: <br /> :: ''....;.:::.Ot.ilil..:04.Eti '0...1.$.00....t0t0iO4.VOitfi4.; . :-.• i -----• <br /> Number of Heads --_ <br /> rk done pursuant to <br /> 4CKN0et2EDGEMENn l have <br /> al reviewed this <br /> of a perm t confirm lauthorizes approved work and nodeviations therefrom.tDeviations must first be authorized in wilting froms permit must comply tith <br /> he <br /> Iowan#federal, tale,and local law.hgranting <br /> 3uildfng beforeOffrcialbel g authorized und=•=" lrcumsfance.l am the owner,orf am authorized by the owner of this property to perform the work for which application is made, <br /> nd/comply with he Ste:Contractors • 18.27 'CW and 298.200A WAC. _City of Everett Official Use Only <br /> �' / "! ;� l cS PERMIT 11 o l n <br /> ,.,.,A.•rnrrfflnr edAgent Signature <br /> Date (Revised 5/20/2016) • <br />