Laserfiche WebLink
PERMIT APPLICATION <br /> 000401.0. BUILDING /MECHANICAL i PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa,gov i wwweverettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 11II 21;6 sTgEET j�V5 iT W* g87�O("2 Z3 PROPERTY TAX#: 665(02490 301-100 <br /> LEGAL for new construction: Short Plat/subdivision _.....___. Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME; j Fiji TENANT NAME(If Commercial) <br /> OWNER MAILING ADDRESS: STREET q 2.1 132.+ui J "t" . al <br /> CITY & V&-QAIT STATE <br /> OWNER PHONE; /2S- 34,'T 5 440 .OWNER EMAIL: tow , i op 0,601eit4,, <br /> CONTRACTOR NAME'. CO&V> • cSTONE RO F1AJ6 INC. <br /> CONTRACTOR ADDRESS: STREET 17112'f /b"sl. Avairt4.4t• Q #1014. <br /> CITY 4601711641-- S rATE LOA- ZIP 98)/Z,._,. <br /> CONTRACTOR PHONE; .Z6- tiler. R EMAIL:_ /I/ !CONTRACTO44 CORIVS� :� <br /> E. <br /> * t > , * .00" <br /> CONTRACTOR LICENSE#(REQUIRED): cop.Nrimo.1.1cfri CITY OF EVERETT BUSINESS LICENSE#{REQUIR.F): 0336-6 <br /> PRIMARY CONTACT: 0 OWNER i.g CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: " '`f,�2s "—J/8S—O/// <br /> SARA coPivls 1 oFciCC O7AivAev e. CONTACT EMAIL: %cl: /` t 1 e^�(',prrJ <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Db1JC LW A)4 Contract Price of Work: $ I'?jf {O!-t CO <br /> PropOsed_Use of Building It 6?f +L,t_l Vial Heat Source: El Gas ❑Electric ❑Other_ <br /> Building Type. I SFR-Detached ❑SFR-Attached ODuptex I MuIft-Fart>;iiy4 of Units: ❑Commercial El Industrial <br /> Type of Project. ONew ❑Addition ❑Remodel rikepair DTA. ❑Sign I sprinkler El Demolition ❑C#iange of Use <br /> DESCRIPTION OF WORK: kose <br /> iNzis:i,y Remn.e. terpripor.L.heyi e, / f rz, yt'i'it 6,171,0V4419'07 <br /> ASSOCIATED BUILDING PERMIT#(Cif applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <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 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,L Other <br /> SPRINKLER l SUPPRESSION SYSTEM <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,I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and!comply with the State Contractors Law 18,27 RCW and 296,200A WAC <br /> City of Everett Official Use Only <br /> PER # <br /> ice'4< ';',.� > .•��" 4)Owner Authorized Agent Signature Date ilVevised 5101/201#9) <br />