Laserfiche WebLink
VI I I I PERMIT , PPUICA.TII <br /> BUILD ?MECHANICAL/ PLUMING/SIG RINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> viiiiwy <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 ((E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> 'Mine or Black lids Only Please) PROJECT SITE I r FORMATION <br /> PROJECT SITE ADDRESS: 7?� t O t� yz 1 I PROPERTY TAX#: <br /> if <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONT 1CT INFOMATO ca; <br /> OWNER NAME: (4!Yi ..,,„..,,,,z7 TENANT NAME(If Commercial): 7-6��i 45,--,7_, - � lSL <br /> OWNER MAILING ADDRESS: STREET tie) (c2V/vrt7/ jZ b lM it'i t4 15-Z33 <br /> CITY // STATE ZIP <br /> 9 OWNER PHONE: 579 3 -l ' i751 OWNER EMAIL: Ccs 12'� 1 134/'i''t et/l c +'4- <br /> CONTRACTOR NAME: 6VV ,.) vi/4 (00A- <br /> CONTRACTOR <br /> 0WCONTRACTOR ADDRESS: STREET STDO / Tb- D7 • 51") ,/� <br /> CIN i.,ky/'v�/f�, STATE �('C ZIP g 5 1.3 <br /> CONTRACTOR PHONE: LOS 9 2Z0`6 CONTRACTOR EMAIL: „L, <br /> CONTRACTOR LICENSE#(REQUIRED): L 0\3 * g3'2VCt CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): _\ ('- g(4 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR Nr OTHER(Please Specify) L <br /> CONTACT NAME: CONTACT PHONE: C.'Z,S 1)-t,�j 6-1;1-5 <br /> 1CaA 11 0 CONTACT EMAIL: Z ► _ .:\,,) LoWtt, 0 c c./tit°. S <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: o wt .t at. Contract Price of Work: qq/ <br /> Proposed Use of Building: Cavt• M tA+- • Heat Source: ❑Gas ❑Electric •Other <br /> Building Type: @SFR-Detached ❑SFR-Attached @Duple f❑Multi-Family-#of Units: ' Commercial ❑Industrial <br /> Type of Project: @New @Addition @Remodel ❑Repair,)T.I. @Sign @Sprinkler N .ition @Change of Use <br /> DESCRIPTION OF WORK: <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL 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 /> NC-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 /> SIPRINKLE'=: /SUPPRESSION SYSTEM <br /> Chemical or Water 1 No.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.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 w' the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> �-� /0 Cl -- PERMI <br /> ��1. O —© <br /> Owner/Autized Agent Signature <br /> Date (Reised 9/23/2016) <br />