Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING I MECHANICAL/ PLUMBING I SIGN I SPRINKLER/ DEMOLITION <br /> Nevf0- CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-5857 1(E)everetteps@everettwa,gov 1 mkw everettwa.govipermits <br /> (Blue or SloOk**Olty Plitasirl<14, i4.. .PROJECT•EITCINFORMATION <br /> PROJECT SITE ADDRESS: ..102e;"-- 114,4g6z/god 1212 PROPERTY TAX#: (e)3.4;t?3-600—11,(7-0Q <br /> LEGAL for now construction: Short Platiseedivis,on Lot No. tattoch copy of tong legal descrioon) <br /> CONTACT INFORMATION <br /> OWNER NAME: OCASF.,.. JZ101...er$ TENANT NAME(if Commercial): <br /> OWNER MAILING ADDRESS; sTREET qo 25 fotitztri4) gc, <br /> err' .JelfIr^-- -Tr STATE (A)* „ 2'P 9 t3)1.03 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: , ,STPEET <br /> CITY STATE :JP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REOUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR XOTHER(Please Specify) 11c 7J4(— Fpr,Q00i '2- <br /> CONTACT NAME:6004 5 tlati.244.-:F.14.44.0 ) CONTACT PHONE: <br /> Z.-- F1- ‘11-LIV-40(> SE CONTACT EMAIL: 3e4_,„€att.IK.s-t-r- f (,0444. <br /> BUILDING,PERMITAPPLICATION <br /> Existing Use of Building: r t‹.. Contract Price of Work:$ <br /> Proposed Use of Building: .54:k.-- Heat Source: OGas OElectric °Other <br /> Building Type:,)afFR-Detached OSFR-Attached °Duplex 0Multi-Farnity4 of Units: 0Commeroiet C3Industriai <br /> Type of Project: ONew °Addition °Remodel ORepair 01-.1. OSI9n °Sprinkler DDemolition °Change of Use <br /> DESCRIPTION OP WORK: KEtz...1€5T1' 004 clef,. :) DUcAcpiezvity., Tag_ hk5Trgitat <br /> D91140 LAM"- fp koe_ DieAtowxg* AgE., .14 P I,4 6 <br /> ASSOCIATED BUILDING PERMIT#(if ap.licable): <br /> MECHANICAL PERMITAPPLICATION ' ,, <':'PLUMBING PERMIIVAMikATION <br /> Type of Project: New Addn Alteration Repair Typo of Project: New Addn Alteration Repair <br /> a:of #of #of <br /> List of Fixtures <br /> ofListList o.,,,,Fixtures List of Fixtures List betures <br /> Fixtures FixturesFixtures Fixtures <br /> - - <br /> NC-Air Handling Units dpetlump Toilet Backflo reventer(Inside Bldg) <br /> Forced Air Systems Unit Heater -Bathtub U • <br /> Gas Piping Bader ' Lavatory(Wash Basin) erinking Fountain <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 /> Clothes D e aookups Other: Clothes Washer Medical Gas <br /> Range H.i.ci Water Heate Other: <br /> Exha . Fan Sink(Se. ceiBariMopietc.) Other; <br /> RNKLERJSUPPS. $OWSYsTi <br /> 'Chemical or Water I INo.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information 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 deviations therefrom,Deviations must first be authonzed in wnting from the <br /> Building Official before being authorized under any circumstance.lam the ovaler,or tam authorized by the owner of this property to Perform the work for wfnon application is made, <br /> and I comply with the Slate ntractors Law 18.27 RCW and 286,208A WAC. <br /> 1 401,0# City of Everett Official Use Only <br /> PERMIT# <br /> Arit, 1.4,10,,zor <br /> irlt litt I ti- 3lt -0 1. <br /> ow le <br /> gent SignatureDate (Revised 912 01C6) <br /> Ada 0 / <br />