Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> "Iiii0111CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue'or Black-Ink:Only Please) PROJECT SITEINFORMATION <br /> PROJECT SITE ADDRESS: 126S CRAFT,MitaJ (AM y 'jt4i T S. 10 ct PROPERTY TAX#: I.Sg S7©c4 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION. <br /> OWNER NAME: et-tG�I.Jr} iQ. c.1 •776.1.1 A)6,1 `LL TENANT NAME(If Commercial): A LLt€WA7-C-ie (xfi7')G c.E.Q.y <br /> OWNER MAILING ADDRESS: STREET /ZD 5 cic417"15 p3- AN MA y su-t`TE lo y Cj <br /> CIp <br /> �/ TY �V6-4-T� ) (. <br /> STATE ( <br /> R ZIP f 20 <br /> `F <br /> OWNER PHONE: 'ZS- 'l'04 '4'106 OWNER EMAIL: l in foa4Ixe-SKtA'(ee-dfS ill na IP iCO Owl <br /> CONTRACTOR NAME: R Q 7` IF$'Ct L 4A)1 1 at-T- e le Vi cesl 1'N C . <br /> CONTRACTOR ADDRESS: STREET Gj l 2O (2 Ave.. S , <br /> CITY Sea-6-(e_ STATE vj ZIP 1[p 08' <br /> CONTRACTOR PHONE: 2-0 to.124 Oct 4 6 CONTRACTOR EMAIL: 3,S c�cue,b I y g_`rft 00 r CO W'. <br /> CONTRACTOR LICENSE#(REQUIRED): R-'7/OOD.iecog8 QL CITY OF EVERETT BUSINESS LICJENSE#(REQUIRED):g$162j <br /> PRIMARY CONTACT: 0 OWNERCONTRACTOR� 0 OTHER(Please Specify) �� <br /> CONTACT NAME: CONTACT PHONE: 2.0 L ' 7 710'OS 443 <br /> 3A-( Sc-44NG8 C.41 CONTACT EMAIL: ,rsGinvtet°if in«)Ci . CO w1 <br /> . ' BUILDING PERMIT APPLICATION ,,„ <br /> Existing Use of Building: Contract Price of Work:$ 'Li CI 6'U'*CO <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.I. ❑Sign ['Sprinkler ['Demolition ❑Change1off Use <br /> DESCRIPTION OF WORK: f N5-r�p�LLA_.7-tc, N O©K" t7F ANSUGam. (A3CT C(`6M(GIt•(, <br /> 5(t2 .5(A PIS.€SS(atJ Desi-e w\ (N`rCt &Ecc •(foci . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL'.PERMIT APPLICATION ,.:, t 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 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 Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SP: ERI SUPPRESSION SYSTEM:':' <br /> 1 ,heroic-.or Water I "7 No.of Heads <br /> ACKNOWLE• -r NT: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 before 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 with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> _.rte, ® t P R #mak --DOR <br /> Owner/Authorized ••ent Signature Date (Revise /2 /2016) <br /> 4.C.. cid 16 t- UiA-- l 1--- ,,,,,,Yz-- <br />