Laserfiche WebLink
PERM17 APPLICATION <br /> BUILDING /MECH/aNICAL/ PLUMBING /SIGN /SPRINKL�R/ DEMOL[TION <br /> CITY OF EVERET f PFRMIT SERVICES � <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257--II810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> PROJ�G'�°SITE IfdF�➢3MA'f'10�1 <br /> PROJECT SITE ADpR S• � � � PROPERTY TAX#: <br /> _ l- I <br /> LEGAL for new construction: Short Plat/subdivisi n Lot No. (atfach copy of long legal description) <br /> , <br /> � <br /> CONTACT INFOFtMAT10Pd i <br /> OWNER NAME: � � }�s�,l' �� >.P�"TENANT NAME(If Commercial): I <br /> OWNER MAILING ADDRESS: sTR�e ' � �Q t `i;j '�. <br /> I <br /> c�— �/� i <br /> ����� {�1 cirr � STATE �G�� ziP <br /> OWNER PHONE: OWNER EMAIL: <br /> _ _ _ <br /> CONTRACTOR NAME:�� � LL, � ' �S�r � ' <br /> t'� �''� C�.'�. I <br /> CONTRACTOR ADDRESS: sraeer � � ! <br /> � , '�l ( - � <br /> � CITY �%� �1 STATE �� � 7_IP � <br /> CONTRACTOR PHONE:L��j "I � ����� CONTRACTOR EMAIL: • " ��Q„1 (� � ' ti � CF'1 �� 1v/ � � <br /> CONTRACTOR LICENSE#(REQUIRED): ', � 1 � � ITY OF EVERETT BUSINESS LICENSE#(REQUIRED)Z�[?� �7 � <br /> � <br /> PRIMARY COMACT: OWNER ❑CONTRACTOR ❑OTHER(Please Specify) �, ; <br /> CONTACT M�:. ` COIdTACT PHONE: � ���� '' ��i <br /> �'1 +��� ��-�C I � CONTACT EMAlL: <br /> � <br /> _,-- - i <br /> ` BUILDING PERMiT APPLICAT,ION - '- � <br /> Existing Use of Building: "' � �� Contract Price of Work:$ L,f}Cy�� � ' <br /> i <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other j <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: Commercial ❑Industrial � <br /> Type of Project: ❑New C1Addition ❑Remodel epair ❑T.l. ❑Sign ❑S rinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: �C ��' O f �����,�� y <br /> �:rm o� � � �'-�, ��`''� � <br /> i <br /> ASSOCIATED BUILDING PERMIT#(if applicable): `�'� �� � <br /> MECHANICAL PERMIT APPLICATIOId _ PLUMBING PERMIT APPLICATION ; <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New Addn _Alteration _Repair <br /> �°{ List of Fixtures #of List of Fixtures �°f List of Fixfures �°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fi�ures <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 Fountain ;: <br /> Water Heafer Refrigeration �Shower Ploor Drain <br /> r <br /> Gas Firepiace Wood Stove Kitchen Sink&Disposal Grease Trap �. <br /> i_ <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clofhes Dryer Hookups Other: i Clothes Washer Medical Gas ' <br /> Range Hood Water Heater Other. (, <br /> Exhausf Fan ' Sink(ServicelBar/Mop/etc.) Other: <br /> SPRINKLER/$LIL��'R�SSION SYSTEM <br /> __ _ . _ <br /> Number of f leads ' <br /> ACKNOWLEDGFMENT 1 have revfev✓ed tiiis applir,ation and confirm the informafinn contained herein is true and correct.Work done pursuant to this permif must comply with ' <br /> current federal,sfate,and local law.The yranting o1 a pennit onty authorizes approved wodc and no deviations therefrom.Deviations must firsf be authorized rn w�iting from the <br /> i�, <br /> Building Official be(ore being authorized�mdcr any cirr.umstance.l am the owner,or I am authorir.ed by the owner of this properiy to perfonn tile work for which application is rnade, � <br /> i' <br /> and 1 comply wifh fhe Sfafe Contractors Law 18.7_7 RCW and 29Fi.200/1 WAC. <br /> City of L-'vereft Offrcial Use Only <br /> � � PFRMIT � � _ �� <br /> Z c <br /> O ne Authorized Agent Signature ate (Revised 90/7?J201(i) ' <br /> �� <br /> c <br /> � <br />