2011 ADAMS AVE 2018-04-19 - Laserfiche WebLink

PERMIT APPLICATION BUILDIN�CHANICAL/ PLUMBING /SJGN /�NKLER/ DEMOLITION GITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.govlpermits (Blue or Black Ink Only.Piease) PROJEGT SITE INFORMATION PROJECT SITE ADDRESS: ' j �i� PROPERTY TAX#: LEGAL for new construction: Short Plaflsubdivision Lot No. (attach copy of long legai description) -CONTACT INFORMATION ' OWNER NAME: � TENANT NAME(If Commercial): OWNER MAILING ADDRESS: s-rRee-r 2.O�( � �CITY � � � STATE �,�� ZIP 28� OWNER PHONE: �2 � 2'� OWNER EMAIL: CONTRACTOR NAME; O��Me t� CONTRACTOR ADDRESS: sTReer crrr sTn� ziP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CIN OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING`PERMIT APPLICATIO � Existing Use of Building: Contract Price of ork:$ Proposed Use of Building: Heat Source: �Ga ectnc ❑Other Building Type: �;SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family�#of Units: ❑Commercial ❑Industrial Type of Project: ❑New �Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: � �� , � � � � mC�u ,,�,,�ir'�'C�'1 q2s �pcP i.,n� �.m �c.c� tm� v � �iJ ASSOCIATED BUILDING PERMIT#{if a licable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn _Alteration Repair Type of Project: _New Addn _Aiteration _Repair #of Lisf of Fixfures #of �st of Fixtures #of /rsf of Fixtures #of /�sf of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bidg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPP.,RESSION SYSTEM : , ` Chemical or Water No.of Heads ACKNOWLEDGEMENT.•l have reviewed this applicafion and confirm the information contained herein is true and correct.Work done pursuant to this permit musf comply with current federal,state,and local law.The granting of a permif only authorizes approved work and no deviafions therefrom.Deviations musf first be authorized in writing from the Building O�cial before being authorized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to pertorm the work for which application is made, and I comply with the St te Cont c rs Law 98.27 RCW and 296.200A WAC. � Cily of Everett O�cial Use Only _ / PERMI # �f��(2Qf� � Owner/Authorized Agent Signature Date (Revised 9/23/2016)