Laserfiche WebLink
PERMII'APPLIC�►TION <br /> �UfLDII IVIEGHAIVICAL./ PLUiV161NG /SIGN '�1R1�CL�R/ D�flIIOLITIOM <br /> CITY OF EVERETT PERMiT SERVIG�� <br /> � 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everetfwa.gov� wwvd.everettwa.gov/permits <br /> (�lue or �lack In�Only �lease) PB�OJECY'Sl'T�9Id�012MAY'IOR9 <br /> PROJECT SITE ADDRESS: � +�� ��`7��,�G 1�"f�G��Lz/',I PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision � Lot No. (attach copy of long legal description) <br /> " CON'Y'I4CT IPJFORMATIODI <br /> OWNER NAME: � �,����+' %� �� � TENANT NAME(If Commercial):�4,4�tt 5 �✓Q'G1 � � <br /> C�" • C�.� <br /> OWNER MAILING ADDRESS; sTReer �fS� „y r !� � ��} r '� <br /> � �� �," � ' `� �'{ " STATE I,�l�^ ZIP � .,��� . <br /> OWNER PHONE: � (,�' "��C3 °"� �}��7 OWNER EMAIL: ��`'� . ,: � J --� r�j%J i�E�'(,'/f <br /> CONTRACTOR NAME: ,�J��I�C� J � , � fI� <br /> CONTRACTOR ADDRESS: srReer I �/� �,� �I� � � <br /> f�7 � � <br /> CI7Y "(` � .� 'v. , I r((��. * STATE ' ZIP <br /> CONTRACTOR PHONE: � �j � CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): � <br /> PRIMARY CONTACT� OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: ���'��� �f J������i' CONTACT PHONE: <br /> ✓ •. <br /> CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: �,�1 Y� Contract Price of Work:$ <br /> Proposed Use of Building:`�� �1'j ;� Heat Source: ❑Gas �lElectric ❑Other <br /> Building Type: ❑SFR-Defached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New �Addition ❑Remodel ❑Repair ❑T.I. �1Sign ❑Sprinkler �E1Demolition ❑Change of Use <br /> DESCRIPTION OF WI�RK- <br /> ��a�dJ� i!�� C' c c oG� (l�=��"s-���.S'.��/� -�- � ��� r,��fr,�,� <br /> -�. � C' �/ J' <br /> tn�N� . 1�cc������.� � c lia�/�,�c ��� � �h'�' � � � � , <br /> ASSOCIATED�UILDING PER'M1T#(if�pli�abl� �������'�j/� ��'f' � �i (/1�� � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alterafion _Repair Type of Project: _New _Addn _Alteration Repair <br /> #of Lisf of Fi�ctures #�f List of Fixfures #�f List of Fi�ctures #°{ Lisf of Fixtures <br /> Fixfures Fixfures Fixfures Fixtures <br /> A/C—Air Handling Units Heat Pump 1 Toilet Backflow Preventer(Inside Bidg) <br /> Forced Air Systems Unit Heater Bath#ub f Urinal <br /> Gas Piping Boiler� � Lavatory(Wash Basin) Drinking Fountain <br /> Wafer Heater Refrigeration Shower S" Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Wafer No.of Heads <br /> ACKNOWLEOGEMENT.�I have reviewed this application and confirm the information confained herein is true and correct.Work done pursuant to this permit must comply with <br /> current federal,state,and/ocal/aw. The granting of a permif only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Burlding Offi ial before being autho"zed under any circumstance.l am the owner,or I am authorized by the owner of fhis property to perform the work for which application is made, <br /> and l co ,y 'h fhe Stata r..,nt �*��{aw 1827 RCW and 296200A WAC. <br /> City of Everett Otficial Use Only <br /> PERMIT# <br /> -- _ ���,a a�� � -�� :�.. .�� �_ <br /> tnr ert,4pthor•i� • ignature Date (Revised 9/23/2016) <br /> �/ <br /> �Z <br />