Laserfiche WebLink
PERMIT APPLICA'r''I ' <br /> BUIL�U I MECHANICAL/PLUMBING 1 St�l�SPRINKLER/DEMOLITiON <br /> CITY OF EVERETT PERMIT SERVtCES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> {P)425-257-8810 � �AX 425-257-8857 �{E)everetteps@everetiwa.gov� www.everettwa.govtpermits <br /> (B{ue or Black/nk Onl Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: ��`�ti �aie �i1�'"f'�i���C 1�•1�L� ���'-��y PROPERTY TAX#:.���J�'���°'��ir�a�� <br /> LEGAL for new construction: Short Piatrsubdivision Lot No. (attach copy of long legai clescription} <br /> CONTACT INPORMATION <br /> OWNER NAME:�`�"'t�G{�$R�p6rG�f�-�'�f'i����'-�'[�-TENANT NAME(tf Commercial): (V�,�"�'(' -�_ � <br /> OWNER MAlLING ADDRESS: srnEEr �M3��C�U��� G��T�- ��iT�'o ��C� <br /> CITY �����,.i„�C� STATE ZIP ��'i t� <br /> OWNER PHONE: OWNER EMAIL: ,,' � � <br /> CONTf2ACTOR NAME� ��, " ,� - r� ' 1 ,. -- � e;, j� � <br /> CONTRACTOR ADDRESS: sn.eer �• V }-�'�I��,j(.��i '"��� � <br /> crrv �����+'t'� srA� na��9�-'�� <br /> CONTRACTOR PHONE: �i�,;r'�.,:�'��'3;��,��i CONTRACTOR EMAtL:y= ,� ' ' i�. '�„�;�,, ' <�,�;�, �' � <br /> CONTRACTOR LICENSE#(REQUIRED): .S•�L'��C/7/i L��1�t�'1C CITY OF EHEREIT BUSiNESS IICENSE#(REQUfRED): (����� <br /> PRIMARY CONTAGT: ❑OWNER CONTRACTOR ❑07HER(Please Specify} <br /> CONTACT NAME: CONTACT PHONE: • ,�.�j�"' t �7j <br /> I�l 1 C+�G ��.���� CONTACT EMAIL: � ` a� 6'' . i , "',L' � � � <br /> BUILDING PERMIT APPLICATION <br /> Existin Use of Buiiding: Gontract Price of Work:$ " <br /> Proposed Use of Building: Heat Source: �Gas ❑Electric �Other <br /> Buildi T pe: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Muiti-Famil -#of Units: omme�cial ❑Industriat <br /> T of Pro'ect: �New �Addition ❑Remodel ❑Re air OT.I. Si n �S rinkler ❑Demolition �Chan e of Use <br /> DESCRIPTION OF.WORK: <br /> �c�u�9� ��I C�� w.�ww51�s, o�c��w �t���a) �fl t U,�t���r�'-�v -w�-u—sd��ss <br /> ASSOCIATED BUILQING PERMlT# if a licabie: <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLtCATiON <br /> Type of Projeot: _New Adde Alteration _Repair Type of Project: �New _Addn Aiteration _Repair <br /> ���s List of Fixtwes �u es List of Fixtures ��ures �st of Flxtures F���s Lisf of Fixtures <br /> A/C—Ai�Handiin Units Heat Pum Toilet Backflow Preventer tnside Bld <br /> Forced Air S ems Unit Heater Bathtub Urinai <br /> Gas Pipin Boiler Lavatory{Wash Basin Drinkin Fountain <br /> Water Heater Refri eration Shower Floor Drain <br /> Gas Firepiace Woad Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducti Dishwasher Roof Drains <br /> Ciothes D er Hookups Other: Clothes Washer Medical Gas <br /> Ran e Hood Water Heater Other: <br /> Exhaust Fan Sink Service/Bar/M /etc. Other: <br /> SPRINKLER!SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT.•!have reviewed this application and connrm the information contairied herein is true and conect.Work dotre pLrsuant to th/s permR rrwst comply with <br /> current federal,state,and loca!law.The granting of a pemrit only authorizes approved work and►ro deviations therefrom.Deviations must first be aulhodzed in wriHng from the <br /> Building Official 6efore being authorized under any dreumstance.I am the owner,or I am authorized by the owner of this properfy to perform the work for which application is made, <br /> and I compiy with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Officia!Use Only <br /> IT# <br /> � - .�- � ���� � - <br /> Owner/ horized Agent Signature Date (Reviseaf 9/23/2016) �,o� <br /> I��;� <br />