Laserfiche WebLink
PERMIT APPLICATICII <br /> ..� BUILDING I MECHANICAL i PLUMBING/SIGN/SPRINKLER I DEMOLITION <br /> CiTY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> EtgEEMMMR .. M.:. :.,... , P_ROJ)ECTSiTE INFORM''ATION_,... - <br /> PROJECT SITE ADDRESS:Z?/ 5f4/6-c77.4PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> ;, _ , . CONTACT INFORMATION. ,..,z:_.: . <br /> OWNER NAME:/` ,.. ( e�c/7 7/,y TENANT NAME(if Commercial): Kt i✓,�4 seI 1. 644-s <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: �G -- ,(3,9, "-Z77 OWNER EMAIL: <br /> CONTRACTOR NAME:��p42./GG.1. j(!/,��!%•yJ 4j <br /> CONTRACTOR ADDRESS: STREET 64Z/ fie? ///e-, P/7 C'2/w, <br /> CITY r.A"tee /9e ./ STATE '!� <br /> CONTRACTOR PHONE:` ZG—2,7‘-',15/,7OCONTRACTOR EMAIL:,C7G2h. ��i77d/ �/7d/7j 6/.17" � <br /> CONTRACTOR LICENSE#(REQUIRED):f'/fjk/'e CPI:9,3.74r <br /> CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ,OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 7 2j ' /2 ---795 <br /> 7 ;.‘,,./ c-r7 mil CONTACT EMAIL/0!✓,lib,7�r�/ ��yi1/� c'4 /1/15-47-17/ <br /> y'-_, . .._ .,.:__$ _ V:.:: _.. _,... ._.;BUILDING PERMIT.APPLICATiON _ _ . <br /> Existing Use of Building: Contract Price of Work:$ 5U <br /> Proposed Use of Building: Heat Source: ❑Gas 0 Electric ❑Other <br /> Building Type: ❑SFR-Detached OSFR-Attached ODuplex OMulti-Family-#of Units: OCommercial ❑Industrial <br /> Type of Project: CI New DAddition El Remodel DRepair DT.1. OSign OSprinkler ElDemolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> ASSOCIATED BUILDING PERMIT#(if applicable): °4 <br /> ' mECH .I_NICAL`PERMiTAPPL1CATlION ": PLUMBING,PERMIT APPLiCATION1iI 4}4 i: <br /> Type of Project: _New_ Addn _Alteration Repair Type of Project: New Addn Alteration Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> • A/C Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler s 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 /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM,- . <br /> Number of Heads 1, <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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT <br /> O e/Authorizgentsignature Date (Revised 10/12/2015) <br /> 1 <br />