Laserfiche WebLink
' � � F �' 3 �` a,�:,�� �� � '� r�y�s�.�� ,_ � " �i . <br /> �('" - ` '- � �' . r 3 �„+ �` d . <br /> . � t� ' � • . _y <br /> , ����'����L,O���I� '�'3 ' ', , ��,�� r,<� ��'��`"`�t`'� <br /> ��'��I�� /������f�/����������� ��'�� ����'�����/�����.f�f�� <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.govlpermits <br /> (�lue or Biack Infc Only Pl��se) PROJEGT SI�E INFORMATION <br /> Pf20JEC'i SITE�lDDRESS: �DV f�aY�=rjDK �• PROPERTY T,�(�: Z8��D2't�0yd/�O <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) � <br /> CONTACT INFORMATION : <br /> OWNER NAME: � p c�o( G.-(� TENANT NAiVIE(If Commercial): �f.�t/f % ✓'` <br /> OWNER MAILING ADDRESS: s-rReeT �(.fi/�G�►'�i �'/^O Z7� �� <br /> - cirv S�"�'ra���sco STA� � ziP q���� <br /> OWNER PHONE: OWVNEf2 EMAIL: <br /> CONTRACTOR NAME; �N/ NC tow <br /> CONTRACTOR ADDRE��: sTReer �OZ �+i �� IV� <br /> CIN �H��✓�� STATE. � ZIP {VVo� . . <br /> CONTRACTOR PHONE: ��2j ' g2j "�SD CONTRACTOR EMAIL: C�u�'!l1It�I"SLtI v�t� .O�6M <br /> GONTRACTOIi LICENSE#{REQUIRED): Gf��y��I ����� CITY OF EVERETT BUSINESS LICENSE�(IZEQUIP2ED): G'���pY <br /> PRIMARY CONYACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: GONT�4CT PFiONE: � '3 - �?��• Q/ <br /> ,��a�e'�GO�Of�' �fp�/f�iq Wt•�S�K CONTACTEMi41L:+�C � �GlYI/'V!�°l�'+,�jl1`� I'►% . �N�1 <br /> BUILDING PERMlT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ ��� <br /> Proposed Use of Building: Heat Source: LBGas ❑Electric OOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Dupiex ❑Multi-Family-#of Units: Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition (�emodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: ���Oh.� �`,,� ��?�a // /�� 1��,/�+Ct 9,� G�R$ i���hL��� l.�N17� <br /> l ( ( J `� �� `/ <br /> A�SOCIATED�UILDING PEIZMIT#(if applicabie: <br /> MECHANICAL PERMIT APPLICATIOMi PLUMBING PERMIT APPLIC�ITION <br /> Type of Project: _New 6lddn Alteration _Repair 7ype of Project: _New _Addn Al4eration _Repair <br /> ��¢ lrst of FixYures �Of LisP of FixPures �°¢ List of Fixfures �°g Lisf of Fixfures <br /> FixPures Fi�ctures Fixtures Fixfures <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. Ciothes Washer Medical Gas <br /> Range Hood Water Heater Other. <br /> Exhaust Fan Sink(Service/BarlMop/etc.) Other. <br /> SPRINKLER/SUPPRESSION SYS"rEM ' <br /> Chemical or Water No.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 wifh <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 O�cial before being authorized under any circumstance.I am the owner,or!am authorized by the owner of this properiy to perform the work for which applicafion is made, <br /> and I comply with the State Contracfors Law 98.27 RCW and 296.200A tA/AC. <br /> City of Everett Official Use Only <br /> � PERMIT# <br /> � � �7 <br /> Owner/ 4ho ent S' naY re Date (Revised 9/23/2096) / <br /> 1 <br /> � <br /> _� <br />