Laserfiche WebLink
• <br /> PERMIT APPLICATIO I— <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> 0,677 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.everettwa.gov/permits • <br /> (Clue ®r Mack Ink®.nly_Please) PROJECT SITE INFORMATION • •• - _ <br /> PROJECT SiTE ADDRESS: 5:2-v w r //if/e0 / J PROPERTY TAX#: r.43054/20.030/9 zes <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> . . ..CONTACT.iil FORMATION . . <br /> OWNER NAME: vk/O ...(„10. -et TENANT NAME(If Commercial): BD�f>�� LIQ p��,vCp <br /> OWNER MAILING ADDRESS: STREET 9f-of�. 5/,a t y Init. Q� <br /> CITY �i�/��l 6 �� STATE *'4- ZIP ZQ 2.9rD <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: - . ..1 6T e-ra: (4cLT iAlG rc- <br /> CONTRACTOR ADDRESS: STREET 2-I 20 (.1 1 Aug • <br /> CITY 11TT STATE (A/A— Q ZIP (�SOO/ <br /> CONTRACTOR PHONE: 4°2-5.9-c 2 a'3//4 . CONTRACTOR EMAIL: /l/f4- Cp ej°JP/ . <br /> CONTRACTOR LiCENSE#(REQUIRED): EV`r24.3S 0.2.24 T- CITY OF EVERETT BUSINESS LiCENSE#(REQUIRED): dj to • <br /> PRIMARY CONTACT: 0 OWNER RCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NA CONTACT PHONE: 4 7 s-�s1 dnje f VWilk lv A4 CONTACT EMAIL: ,1440462 404 6614- <br /> .. • ... . .. BUILDiNG PERiIIIIT APPLICATION . <br /> • <br /> Existing Use of Building: p 6414.ee l Contract Price of Work:$ 1400 <br /> Proposed Use of Building: J a CYPII,cC, Heat Source: Lias ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family #of Units: L Commercial ❑Industrial <br /> Type of Project: ❑New DAddition ❑Remodel fdRepair DT.I. ❑Sign ❑Sprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF O K: <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MEc$ANiCAL.PERMIT APPLICATION • • . PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_ Addn Alteration Repair Type of Project: New Addn Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—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 R• efrigeration Shower _ Floor Drain <br /> Gas Fireplace 7 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 /> aft?RINKLER/•OU(PPkESSION SYSTEIIUI <br /> Number of Heads <br /> ACKNOWLEDGEMENT:l 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 circumstance.lam the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# - __ __ <br /> /1/30//7 n4/ 7/.1.101 <br /> roVgi7AuthOrize nt Signature Dat (Revised 5/20/2096) <br />