Laserfiche WebLink
PERMIT APPLICATIOI` <br /> 'IPBUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION �-�f p6 L,3 J(`3 (90 <br /> PROJECT SITE ADDRESS: 2 7 2.2 leo ca,) AAA- o/c---4"-71- PROPERTY TAX#: } <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 514 II . W 1'l,% '$L TENANT NAME(If Commercial): el G '1`1 . eft-R.74 <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: C519-0) *'0..- / OWNER EMAIL: <br /> CONTRACTOR NAME: '`r`) W( rr\21_ I 10 - tfN/ <br /> CONTRACTOR ADDRESS: STREET 1` <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: Oda Ill-- *670 CONTRACTOR EMAIL: ;13 , )1=i7L,Aa11 P �'ij'Pt . E� <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNERICi�"GONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Ct' &) lin od---70ppsa ,cb ivickefe4 <br /> I CONTACT EMAIL: 2/4.44v0 1r'X) a i F f e G /1.- j , <br /> BUILDING PERMIT APPLICATION J <br /> d, <br /> Existing Use of Building: Contract Price of Work:$� 'r 2(O � 4r'2 J1--b- — <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T ❑Sign ❑Sprin ler ❑Demolition ❑Change of Use <br /> . . <br /> DESCRIPTION OF WORK: 1�( yJ4 YrAleVel i1'• i 4 I /40207 yi y , L• F-7A.71,.Yt <br /> P +Vc-(14 <br /> Z1 0 - 03`1' <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APP;ICATION <br /> Type of Project: _New Addn _Alteration Repair Type of Project: _New _Addn VAlteration _Repair <br /> #of List of Fixtures #of List of Fixtures #°f List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump Toilet 2. Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler "3 Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove 1 Kitchen Sink&Disposal I Grease Trap <br /> Gas Range Ducting 1 Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan 3 Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I No.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 authorized in writing from the <br /> Building Official b;ore being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply wit, •,.tate Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> P <br /> INit .d......cm <br /> Owner/Autho . . et e Date (Revisd 9/23/2016) / ' <br /> i <br />