Laserfiche WebLink
PERMIT APPLICATION ;� ORIG1NAt <br /> BUILDING /MECHANICAL/PLUMBING /SIGN /SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> 9tn i c i�,�" x � i 4 „,��;� riii�. i a� M -� w — z� <br /> ��2� � = - � ��s i�!i��.��C� ����INf,ta�IV��►�"����` ��`�oy = �« �� _ ��� a ;� <br /> �. P� <br /> PROJECT SITE ADDRESS: ����� �' /+� PROPERTY TAX#: ,� (� <br /> V <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> ���39@ `7(�i i�;'!i iii as, i��,'ti'74�'�� ilii h v�,��.i� __ � ? iy:�N ^d '��li II h��ii? 1' ` ".`�,:.:., ��I i .�i1�IlFrfi��i��p�; >:".�rii Y.�S�FL�i:: <br /> ,��i5u S s,.+ y,,i����I�;�,I�(�ii i� r i P��i ti ;ili����; (iy�J���°'IiGk i� �:� �i.•� � IYI'�..��� .,i a��i�I�:a�al A;��ai .,'�'�il��' �� i� i �����a1Fgp ;;i�ili <br /> i,otl i Ii ���^J��i �nw-�I- �i�i � �7'��� Urdil���'ia �Iil�ail�N�7�� i��I.����� �A1'+'��...�:a� �:.6i��wo F.ut�r In .in I II. h1 Y�P;1i�4 �l�1Sul"�w <br /> � <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTReer � <br /> CITY STATE ZIP <br /> OWNER PHONE: Z "� Q^' OWNER EMAIL: � <br /> .... �, � . . m __ _ <br /> ... �_. . ..e, � _._ <br /> �_,. _� . . a w . ��,. <br /> CONTRACTOR NAME; 'U � <br /> CONTRACTOR ADDRESS: STREET � <br /> CIN STATE -- ZIP <br /> CONTRACTOR PHONE: � ` �� CONTRACTOR EMAIL: ` <br /> CONTRACTOR LICENSE#(REQUIRED): ��/ � CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> .0 � �� ,,,,.,., ,,� ,. .�--. � , � �.� w .,, . . .�,�..�n. _ . , ,r,., ,� .. ,�.- <br /> M __,�.�,� � _e, � � �. . <br /> PRIMARY CONTACT: ❑OWNER [�CONTRACTOR ❑OTHER(Please Specify) <br /> CO TACT NAM : CONTACT PHONE: — l — <br /> ��J6� {��,� e � CONTACT EMAIL: ` �/ <br /> � � ,�,�ai` 'A s�n I lal � � .._ n r. n.�,. -� a ,-;,,,�,r�x.��r.� .rT-.,,�n+ i �'�r ui .. <br /> �ay�.�i � .9i.5 �� � G x�i ��i � �.u i#e ��l �;, �—' ,i. r i4q�.4�� � '� ���� i��i��hG���r�fii,�fiau� � "'��i��������y ���' <br /> '�,:,r���� �t. �� �Viuhiy"" ���w�i��i�GDi3� :�. ,�� � �C„ ����� il, �!'.�;��� �.��� iiaiii s iiiF,�� �O�iic,�rM� . ��ru, .di.�l t PIui�I�lh'�d <br /> �•, <br />, Existing Use of Building: � Contract Price of Wor . � <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric �Other <br /> Building Type: SFR-Detached ❑SFR-Attached ❑Duplex ❑Mu�ti-Family-#of Units: ❑Comme ial ❑Industrial <br /> T e of Pro'ect: ❑New �Addition ❑Remodel Re air ❑T.I. ❑Si n ❑Sprinkler ❑Demolition han e of Use <br /> DESCRIPTION OF WORK: <br /> ;� ��� ����d r�a ci��� a� . <br /> i -�N c� � <br /> � <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> ,;.,� , ' ,§MECHANICAL„PER�lill�',APPLICA?IQN, ..,. �� . , a.,;� t, , .�PLUM�ING�PERMIT,��`APPLIC%ATION�� �; ,5 .,:,3: <br /> Type of Project: _New Addn Alteration Repair Type of Project: _New Addn Alteration _Repair <br /> #of �ist of Fixtures #of List of Fi�ctures #°f Lfst of Fixtures #�f Llst of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handlin 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 Dr er Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/Mo /etc.) Other: <br /> ,�SPRINKLER,/,�Si�Pf�1�ESS1'ON SXS�EM,�.,, �;' <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 compty with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work�nd 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 /> d I comply with the tate Contractor Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> �� PERMIT� � � D � � ��� <br /> v <br /> t Sfgnat e Date (Revised 10/12/20i5) <br />