Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
PERMIT APPLICATION <br /> BUILDING I MECHANICAL I PLUMBING I SIGN I SPRINKLER I DEMOLITION <br /> z,:tii,w,""""v CIM OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-25T-8810 i FAX 425-257-8857 i( )everI wonveveaettwa,govlperrnits <br /> (Blue or Black Ink Only Please) PROJECTSSITEINFORMATION; <br /> PROJECT SITE ADDRESS:6524 Berkshire Dr. PROPERTY TAX <br /> LEGAL for new o nstrctian: Short Piat/subdMsion Lot No. (attach copy of long legal desolation) <br /> CONTACT INFORMATION <br /> OWNER NAME: Judith Bronson TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sneer 6524 Berkshire Dr. <br /> crry Everett STATE WA z p 98203 <br /> OWNER PHONE: 425265.0191 OWNER EMAIL; <br /> CONTRACTOR NAME: Hamblen&Sons Heating N <br /> CONTRACTOR;ADDRESS: sreEEr 7409 68th AVE NE <br /> ary MARYVILLE STATE WA ZIP 98270 <br /> CONTRACTOR PHONE: 425-501-0123 CONTRACTOR EMAIL: harnblen:<sOns&grnaiLCOrrt <br /> CONTRACTOR LICENSE#(REQUIRED): HAMBLSH933DE CITY OF EVERETT BUSINESS LICENSE#(REQUI :053666 <br /> PRIMARY CONTACT: CI OWNER #CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-501-0123 <br /> TIM ,CONTACT EMAIL: hamblen.sOns@gma .com <br /> BUILDING"PERMIT APPUCATIO1 V <br /> Existing Use of Building: Contract Price of Work:$ <br /> Proposed Use of Building: Heat Source: COGas IJElectric DOther <br /> Building Type: °SFR-Detached °SFR-Attached °Duplex ©Multi-Family-#of Units: °Commercial 0industrial <br /> Type of Project: ©New ©Addition CIRemodel ©Repair CIT.i. CISiign ©Sprinkler CODemolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> , -1,n L..)a� — e--0.jej <br /> JLC <br /> ASSOCIATED BUILDING PERMIT#(if applicable): \ 0 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _,.,Alteration Repair Type of Project _New _Addn Alteration _Repair <br /> #a #of <br /> List of Fixtures #of fist ourtures <br /> F/xiures fres Fixtures Fixtures <br /> Fixtures List of Fixtures <br /> 'AIC Air Handling Units_ Heat Pump Toilet Backflow Preventer(inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal ` <br /> ( Gas Piping Boller Lavatory(Wadi Basin) Drinking Fountain <br /> I Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Woad Stove Kitchen Sink&DisposalGrease 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/Mopietc.1 Other <br /> SPRINKLER t SUPPRESSION SYSTEM <br /> !Chemical or Water 1 !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,end local law The granting of a p.m*only authorizes approved wank and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official hater.being authorized under any circumstance.I am the owner,-or am authorized by.the owner of this property to perform the work for which application is made, <br /> end I aomplywith the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT <br /> T. Hamblen 5/30118PE <br /> M (r) .- Og 2- <br /> Owner/Authorized Agent Signature Date (Revised 912 18) <br />