Laserfiche WebLink
PERMIT APPLICATI• 'i <br /> __ BUILD/MECHANICAL/PLUMBING /SI iii'PRINKLER/DEMOLITION <br /> CITY OF EVERE I I PERMIT SER <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 42057-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> •_•- • 'S.;I:,:V$1:..::•r - •:�:::•.tr_'-'.•„'v:_..r-e: =:.'.:is•: :.:.-.f.+ i i14— i +y� i.t ;�,r..•k_?•_:�: = _-_ '":-:-1.:-.-.:'-::5`•:i'.: <br /> rr-•+ - _ - ..:V��S�`1=:.•tial�7i`.�R"tY�AJ_��lM._=_•y.A�.Y'•.:,!`::;v.•____ _...__. <br /> e <br /> PF [ <br /> vAADID Relsi .. tve?!'+ Vw' a$2Oi PROPERTY TAX#: O 1 it-i 00` <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> :. '... .u.-.5•.r' r:xx. X .<:...•:1•_. v •.•• .. .? :..•:::..-. .: n s _ x....:..u..<S.♦:} if rl...1. <br /> .:•:;;.:�•,:.: r1TA(T;�11f� 8RiVA__. . <br /> OWNER NAME: 0)(1W.4... Spbitsl_ TENANT <br /> NAME(If Commercial):11W1 $ L � 6UJW <br /> OWNER MAILING ADDRESS: STREET Cos O, i1_b' )`NAv V /� <br /> CITY v JV STATE WA ZIP " I . <br /> OWNER PHONE: h2S)ZZg/t*0 ik- OWNER EMAIL . . <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(RE.QUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: O OWNER 0 CONTRACTOR OTHER(Please Specify)I \r 1 kUl l(�te.'' EVCbl . <br /> CONTACT NAME: CONTACT PHONE: 42,S);10 c -Let <br /> � <br /> � , /1 t n, CONTACT EMAIL: �- t-1oc•• cock, itX et Y O 1..(cw <br /> -- _-- -- rte.},.�..__ - = > _.�;.� :LBUiJ�D N;�P�Rtt�i1�;__!it_.._.__�,_._. ._.._. . <br /> Existing[Use of Building: AYNA:i \tA''C CAVAD Contract Price of Work:$ <br /> Proposed Use of Building: C6eR:( V( Heat Source: KGas OElectric 0Other <br /> Building Type: OSFR-Detached I:SFR Attached IJDuplex I:Multi-Family#of Units: Commercial Clindustrial <br /> Type of Project ONew CDAddition °Remodel °Repair 1 T.I. ElSign OSprinkler °Demolition OChange of Use <br /> DESCRIPTION OF WORK: 11,'_ ._: `L►.irrs��....r �� IjArit*ADC 0 RAM � tea' <br /> _=_- - - . ,._ '__- S' • i° -t w eti> NILiv . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> Type of Project: New Addn Alteration Repair Type of Project New Addn Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures <br /> List of Fixtures #of List of Fixtures #of Fixtures <br /> Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump / Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler / Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower 3Floor 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 /> Range Hood Water Heater Other: <br /> Exhaust Fan b Sink(Service/Bar/Mop/etc.) Other. <br /> . •SPRINKLEI lORPRESSLON`SXSTEM> 4;••- <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 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.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and l co-: with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only <br /> ' PERJVII7W -Di?.._ <br /> Owner/Au I .'ent Signature O� �Da I {Revised 1I 10/12/2015) <br /> i <br />