Laserfiche WebLink
LIICHANICAL <br /> PERMIT APPLICATIONIIBUILDING /PLUMBING/SIGN IN <br /> / 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.everettwa.gov/permits <br /> (Blue ar¢lack ink=Only,Please) PROJECT SITE=INFORMATION <br /> PROJECT SITE ADDRESS: 1°l zl ✓irc ��,,� AA.? 5 I ; �, t PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: P4c - r. 45 cfj- ge)tit's ori Ivtc, TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET t K ZO S€ S 6 ' ' S t/r <br /> CITY 75-C pet d e STATE W fT ZIP g g o c Jo <br /> OWNER PHONE: (CIZ Ste) — <3 y 0 C Z 6 m OWNER EMAIL: 3 kms/ ( pOt. . 01)&0 rs < Co w <br /> CONTRACTOR NAME: 44 (A/f 4'Lt t-ri CtseS 4 St-ri//,C,s <br /> CONTRACTOR ADDRESS: STREET /6 O 2Aim 41" Gf c c' o+ ST,n >✓ IOQ P�' 3 # ZZ c <br /> CITY Pi)y 'tI((/✓' STATE 14./AZIP <br /> CONTRACTOR PHONE: 'Z C3- b 7$-3 S 9 ' CONTRACTOR EMAIL: 6rd,,,0.ao n e o.(i °1/4441 e'r'0 <br /> CONTRACTOR LICENSE#(REQUIRED): 4 L-L el A Q 3 f 4 CITY OF EVERETT BUSINESS LICENSE#(REQUI ED):0 (p <br /> _4.) <br /> PRIMARY CONTACT: ,OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: 'T3 "4 a CONTACT PHONE: 25.3 _6 7T_3 S`y 2 <br /> tM t-C 0"1 v' i\, CONTACT EMAIL: "�1��,0., i,A, 'LA A) .L S ‘"--" <br /> BUILDING PERMT:'APPLICATIO <br /> Existing Use of Building:(Ee r .e.,-) itnek.4I4.- t4f0w e rr Contract Price Work:$ ®, 0 Q7 O <br /> Proposed Use of Building: 44,4-1--(-4--S S Heat Source: ` Gas El Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached 0 Duplex ❑Multi-Family-#o nits: commercial ❑I stria) <br /> Type of Project: ❑New Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprin ❑Demolition e of Use <br /> DESCRIPTION OF WORK: -13,„;r J c O I )( (0oast / } Sire <br /> &tA,fL,+n Selo y GL a r. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING,PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Projeot: _New _Addn _Alteration Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of Last fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump Toilet Bac reventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub al <br /> Gas Piping oilerLavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration /Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Dispos Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hook s Other: Clothes Wa r Medical Gas <br /> Range Hood Water er Other: <br /> Exhaust Fan Sin ervice/Bar/Mop/etc.) Other: <br /> SPRIN ER/SUPPRESSION SYSTEM <br /> ICh ical 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•,ly authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circ tan =.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/comply with the State eters Law 8.2 -CW an•296.200A WAC. <br /> q 'City of Everett Official Use Only <br /> /i/ 7 <br /> ( ✓ <br /> {2-02__ <br /> Owner/Authorized Agent Sign - - Date 1 I (Revised 9/23/2016)6) <br /> /2., <br />