Laserfiche WebLink
_. _ <br /> ___ _ _ _ _ _ _ _ _ _ _ _ _ _ <br /> PERAttIT APPL.iCATION <br /> BUiLDING/MECHANICAL/PL.UMBI{�G 1 SIGN /SPRINKLER/�EM4LlTtON <br /> CITY OF EVERETT PERMiT SEf2VtCES <br /> 3�00 CEDAR S7REET,EVEf2ETT,WA 98201 <br /> (F')425-257-8810 � FAX 425-257-8857 j{E)everetteps@everetfwa_gov� wroxw.everettv+ra.govlpermits <br /> {61rr�ar B1aGlc Ink�Dniy PE�ase} PRAJECT SI"�lNFt} ATION <br /> �Raa���so-�--�,�a���ss: �-e ; e . ��....- ��opE�n Y��: <br /> � <br /> LEGAL for new Construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT IN�tJRMATtON <br /> OWN6R NAME: /` Y��C-J''� �� ��{.'Y �'_ TENANT PlAM�(ifi Comrnercial): <br /> QWNE42 MA(UNG Ai3DRES5: szne�r ),!S�J �'' '/ ).r� <br /> r <br /> a7v ��.�,�-L•�'t�,�� sra�e ,��� z�P� <br /> OWNER PHONE: `7<-��j -� �� - �� OWNER EMAIL: <br /> CONTRACTO�NAME: �Y� 2_`_�-> �-�'�`�'"� -�'��✓�"L.�L"i 1�- �L-�� <br /> CONTRACTOR ADDRESS: s�eer �i` �/ '�`�'�'� {'`� ��7 ^--' <br /> C17Y ����.-'��/' � �/ � � STRTE ZiP ' ( <br /> ,��¢�-� �, . <br /> CQN7RACTOR PHONE: � r -� ��- � CON7RACTOR EMAIL:��i'�'�f/L���Y���'j� � ' ��J�' ,� <br /> CQP(TRAGTOR i.ICI�NSE#(REQUIRED): '1��r"��-�- �'�� � 'FS s-7-•�Ll-�' ClTY OF EVERETT BUSINESS LICEN3E#(REQU1FtED): C.� �c�'�� <br /> PRIMARY COHTACT: �OWNER �ONTRACTOR ❑OTHER(Piease Specify} <br /> CONTACT NA . r CE}NTACT PHONE: {��- <�. .���j i.��;�-� � <br /> t r %��� CaNTACT EMAIL: <br /> BURLD�NCi'PERMiT APPLI�A'�`IQN <br /> Existing Use of Buildin : Contract Price of Work:$ � . �� <br /> Proposed Use af 8uilding: Neat Source: f�Gas ❑Electric ❑Oiher <br /> Building T : ❑SFR-Detached FR-Attached ODuplex �Multi-Famil -#of Units: ❑Commerciai ❑Industrial <br /> Ty e of Rro'ect: ❑New ❑Addition ClRemodel Re air ❑7.1. ❑Si n ❑S rfnkier C�Demolition C7Chan e of Use <br /> dESCRIPI'll�N QF WORK_ .. <br /> ('��,, L t�.: I�..2..-6�c� �'"f�L�. c� ,,,�.�,.�1 E�,c��- <br /> ASSOCIATED BUILDING PERMlT#(if applicabte� <br /> ME�i�ANICAI�P�itMt APP�ICA'�'IClN � Pl.�f1Y1�iNG PERfi�1T APPLI�'�RQN <br /> Type of Project: �New Addn ,�Alteratian Repair Type pf Projec@: New Addn �Aiteratiort F2e�air <br /> #of �,p�f of Flxtures #of Lsf vf Fiartures #of List of Fixtures #°� Ust of FJxtures <br /> Fixtures Fixtures Fixfures Fixiures <br /> A!C-Air Handiing Units Heat Pump Toifet Backflow Preventer Inside B)dg) <br /> Forced Air S stems Unit hieater Bathtub Urinal <br /> Gas Pi ing Baii�r Lavatory{Wash Basinj Drinking Fauntain <br /> Water kieater Refrlgeration Shower Floor Qrain <br /> Gas Fire lace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Duetin Dishwasher Roof Drains <br /> Clothes D er hiooku s Other. Clothes Washer Medica!Gas <br /> Range Haad Water Heater Other. <br /> Exhaust�an Sink(Service/BadMop/eic.) Other: <br /> $PRINKI.ER/SUPPRESStON SYSTEM <br /> Chemical or Water No.of Heads <br /> ACKNOWLEDGEMENT.�!hava roviawed this application and co�rm tha irrformation containad herain is hue and co�roct.Wotk done pursuant to this permit must c�mply with <br /> current federal,state,and local taw.7ha grarrting of a permit oniy authorizes approved work and no deviations therefrom.Devrattons must first be aufhorizecf in writing from the <br /> Building O�cral befom being authorized under any circumstance.i am the owner,or!am authortzed by the owner of fhis property to perfonn the xrork(or which application is made, <br /> and 1 compdy with the SYaEe Contractors Law 98.27 RC W and 296.2QQR Wi4C. - <br /> Ciry of Everett O�ciaP Use Only <br /> � ��� �; ��, _ ���+ ._� PERMIT � '�/��� V'� � <br /> - r � <br /> OwnerlAuthorized Agent Signature Date (Revised 9123/20?6} <br /> ( <br />