Laserfiche WebLink
Sep 26 2017 11:47AM Washington Watreaters 8663757454 pag1 <br /> gn- PERMIT APPLICATION <br /> BUILDING / MECHANICAL I PLUMBING /SIGN I SPRINKLER 1 DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 i FAX 425-257-8857 I(E)everetteps©everettwa.gov I www.everellwa.govipermits <br /> (Blue or Black Ink Only Please) PROJECT <br /> TfSIT- /TE INF/ RMATION <br /> PROJECT SITE ADDRESS: a 1i `i kat, PROPERTY TAX#: OLIV60Z gat U QU <br /> LEGAL for new construction: Short Platisubdivision _Lot No.__ (attach copy of long legal description) <br /> �� �� (� �� �I- CONTACT INFORMATION I� f I���. <br /> OWNER NAME: (�J W`MY te �"'+'t.!'''0!!lei--,�7, ff TENANT��/ � NAME(If Commercial): L�i /^t vv d�UE�' L�[L.t4F/i/ <br /> OWNER MAILING ADDRESS: STREET at,2 %Ctek l[ry C F C4 'vS tT <br /> CITY ,"'�„"'hhh STATE 66/A ZIP ! A �' <br /> OWNER PHONE: J�i'W. Q —1 `,� OWNER EMAIL: ..--- <br /> 6 V <br /> CONTRACTOR NAME: W4-5/411061/74L1 4 tai-' f L nH�C 7 r$ �0 f <br /> CONTRACTOR ADDRESS: STRUT 111SS 2— l( Vitt I O "'ox -q� <br /> CITY u^�, / r STATE ZIP q�56 <br /> CONTRACTOR PHONE: 426_gg3_. qg7/ � CONTRACTOR EMAIL: e hi-tif i-HVAL CO61IYZJ4IL, (Orn <br /> CONTRACTOR LICENSE#(REQUIRED): w f0 6O/ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 05 99 4 <br /> PRIMARY CONTACT: 0 OWNER EICONTRACTOR ❑OTHER(Please Specify) <br /> CON ACT NAME CONTACT PHONE: 02, - ' 3-caw <br /> I 06- 11-e Is • <br /> CONTACT EMAIL: IrVt�Vtr iyt. ' a -IL+Om <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: 1v), Contract Price of Work: $ =' - cii .3-35-o <br /> • <br /> Proposed Use of Building: Heat Source: ❑Gas ►a -ctric ❑Other - .. <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Mufti-Family-#of Units: DCommercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair CIT.!, ❑Sign ❑Sprinklert`�❑D,emolition ❑Change of Use <br /> DESCRIPTION OF WORK: ,� /1/,{` t n(,p��h r p <br /> i?*.fjkir it''L �; �� /� �/ kia-161/ <br /> ASSOCIATED BUILDING PERMIT#(if applicable): V" <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Adcin Alteration „Repair Type of Project: New _Addn _Alteration Repair <br /> If of List of Fixtures #of List of Fixtures #of List of Fixtures it°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking 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 Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood t Water Heater Other. <br /> Exhaust Fan Sink(Service/Bar/Mopietc.) Other: <br /> • SPRINKLER 1 SUPPRESSION SYSTEM . <br /> (Number of Heads <br /> ACKNOWLEDGEMENT:1 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 authorized in writing from the <br /> Building Official before being authorized under any cbcumstanc I am the owner or 1 am authorized by the owner of this property to perform the work for which application 1s made. <br /> and 1 comply with the State Contractors L 18.2;RGW and 2, .20011 WAC. <br /> City of Everett Official Use Only <br /> ,( (�( /�� � PERMIT# <br /> �"�v tLL �144 (70(1-. 07/ <br /> O rlAuthorized Agent Signature Date (Revised 5/2012018) <br />