Laserfiche WebLink
��6`�6�'d91�A���9C�a790h� <br /> ���6����G I Y��C�9ANICAN�/ f��.U6�'i�l�l� /S�G6�9 /��h�9i��a�.�C�/��@fl0�.9�"10�9 <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 ' <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everetiwa.gov� www.everetfwa.gov/permifs <br /> ��la�e orr�I�c�6u���nl��I��s�) ����A��`�'��"�� �����i��`���� <br /> PROJECT SITE ADDRESS: SOI�j Z � VF_ IN �V�/LE7T U✓� ggZ�io PROPERTY TAX#: <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. �� (attach copy of long legal description) <br /> �06�Y�AC�' 9N�'ORI�iA�'9�� <br /> OWNER NAME: (,v� L��.� �u� TENANT NAfVIE(If Commerciai): <br /> OWiVER MAILING ADDRESS: s-rReeT�C7I � ,FI-VL W65� <br /> CIN �V�„QG-I�— STATE (/�/� ZIP � <br /> OWNER PHONE: yZ S- ��/-y3 i3 OWPIER EMAIL: <br /> CONTRACTOR NAME; �N1{�,�.�f}rL �Vl(�t���� <br /> CONTRACTOR ADDRESS: srReer ��'S'D 4' �(�'j �` rF'G � <br /> cirr �Q D,�.�S STATE (,V q zia 9$'OZ-6 <br /> CONTRACTOR PHONE: ',�.Q(p-'7� -$7��O CONTRACTOR ENiAIL: OG� ��cTf�r21v2.��id �Gta�f,Gac�n <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(RE(dU1RED):V�" <br /> PRIMARY CONTACT: ❑OWNER (�CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHOfVE: �pFj^ T��9� Sb�JO <br /> �([,,�,��L �l�K�_� CONTACT EMAIL: ��eX-r('��pQS � �jJLJ�lG.�K1 <br /> �111LDING PERMIT APPLICATIO�iI <br /> Existing Use of Building: G 5 Contract Price of Work:$ <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: �SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family�of Units: ❑Commerciai ❑Industrial <br /> Type af Project: .�New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: y� ��� �J 1 (..�, <br /> L� <br /> ASSOCIATED BUfLD1NG PERMIT#(if applicable): <br /> MECFIANICAL PERMI'i'IAPPLICATION P1.d1MBINC; PERMIT APPL9�ATION <br /> Type of Project: _New _ Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of Lisf of Fixtures #of List of Fixtures #of List of Fixtures #of Lisf of Fixtures <br /> Fixtures Fixtures Fixfures Fixtures <br /> A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bidg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Founfain <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 /> Clofhes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRI�JKLEFt/SUP�IaE�S10[d SYS`TEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT.�I have reviewed this application and confirm the informatron 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 deviafions therefrom.Deviations must first be authorized in writing from the <br /> Building Otficial before bein uthorized under any circumstance.1 am the owner,or l am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the St Contractors Law 18.27 RCW and 296.20oA WqC. <br /> • City of Evereff Official Use Only <br /> Z�i `�� PERMIT# ���� <br /> V� � <br /> Owner/Aufhorized Agen ignafure Date (Revised 9/23/2096) <br /> � <br />