Laserfiche WebLink
PERMIT APPLICATION <br /> /111PP40/ /(----.A <br /> BUILDING/ MECHANICAL/PLUMBING/SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> Al <br /> ' y 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 ((E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORM TION <br /> PROJECT SITE ADDRESS:11 32 ,r l _CI(. <br /> bait. „firpi PROPERTY TAX#: ®09 Li .o-o LI 02 0077LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 340 r 1--.l4'? ) '' .S Li,Ce TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET (i 20 Par tc a y 6 <br /> CrTY V V K I`-fee, STATE 6//f61 ZIP f f Z/// l920 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: 12: tiiflt/ fj'i -_ <br /> CONTRACTOR ADDRESS: STREET 1(5 j <br /> CITY CkQ'r`� STATE /G7zIP � � <br /> CONTRACTOR P.ONE: a".1170 ‘/7CONT CTOR EMAIL: biGleCol j 0 A -,;. �_v _� — <br /> 'orCONTRA.. OR LICEN #(REQUIRED):f\l3 iffiv g CITY OF EVERE • NESS LICENSE ”'REQUIRE•A 9"(a i <br /> PRIM(ACT <br /> "Y CONTACT: 0 •WNER COCONTRACTOR 0 OTHER(Please Specify <br /> •C N �► CONTACT PHON:: ,� O F.4 o '-/79 <br /> 0. A t (,,.'(4 CONTACT EMAIL .1061ro 0 //e,/ ®C. .e <br /> BUILDING PERMIT APPLI ION <br /> Existi , Use of Buildin.. 1»',1�17 Contract Price of Wo . f :-,----47--'4%•••• ) OI. <br /> Proposed ..- • : ilding: i � ?V.2elit" i Heat Source: Gas ❑Electric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: }Commercial ❑Industrial <br /> Type of Project: :New ❑Addition ❑Remodel ❑Repair 0T.1. DSign ❑Sprinkler ❑Demolition 76hange of Use <br /> DESCRIPTION OF WORK: PILAftraL41...V+ ' / t c" sII.ie ,:',c(e) Q,. 0,0-a-4 ‘40.5.c <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICAT • <br /> Type o -reject: _New _ Addn Alteration -•air Type of Project: _New Addn _Al - ation _Repair <br /> #of List of Fixtures #of st of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixt ""s <br /> A/C—Ai - ndling Units Heat Pump / Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Sy - s Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash =. '.i) Drinking Fountain <br /> if Water Heater t Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove / Kitchen Si : Disposal Grease Trap <br /> f' Gas Range •ucting Dishwa er Roof Drains <br /> Clothes • er Hookups Ot-- • Clot -s Washer 'cal Gas <br /> Ran.- ood / W.,- .eater Other: <br /> aust Fan / Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> 'Chemical or Water ' No.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 owner of this property to perform the work for which application is made, <br /> and! . .. . e ate Contractors - - W and 296.200A WAC. <br /> City of Everett Official Use Only <br /> • ' , 71r17 <br /> PERMIT13i'1V'1 -- V.62 <br /> • ner/Authoriz Ag Signature D (Revised 9/23/20(16) <br />