Laserfiche WebLink
. _. , ., s �.r,..r-i r rvry <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER / DEMOLITION <br /> CITY Of:EVERETT PERMIT SERVICES <br /> F01 .'E Jr 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (I') l?f, L/-8I11f1 1 FAX 425.2r/-885/ I(C)evrirrrllrrP'Ir!nvnrefly/a.goi 1 yr/rr/.r,ver'a'rra 7,or Mack Ink Only Plenary) PROJECT SITE INFORMATTIIOT <br /> ItOJI?C f sl fl-ADDRESS; ` =WW t{Ci' <br /> P <br /> - ------._Jo i ea.r, f I}ala l' I n e V/1 ei,V 0 r PROPERTY TAX#: <br /> I IGA!.Irn new r.nn'rinualnn Rhnll I I I/,ubillvlsluni <br /> __1_ot No. (attach cop/of long Irgal de..r r;n) <br /> CONTACT INFORMATION <br /> OWNER NAMC: ly ,,� _ IGC ^' <br /> - "c_c_!C�' TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: )l,l l l <br /> _.I_ C) ::71L'. I,.Aflily E lid b iG f <br /> ..- _,_..�..__..-- CIIY 6 ��/ 'TAT. W __ a 2 J <br /> owN_ER PHom7..: [} • <br /> `"`cccc <br /> ____ �� 7 _._ � �l OWNER EMAIL: <br /> CONTRACTORNAME: t-1 eA 11116 <br /> CONTRACTOR ADDRESS: r:n<erT 4'6 <br /> lip iQ <br /> ------------ clre eer/ STATE WA- L..'" V�sr-'.:1 <br /> CONTRACTOR PHONE:(-aS P59 D 5 CONTRACTOR EMAIL: d e4210 1 ert <br /> . (DGrnh.eafi a:. .r art <br /> CONTRACTOR LICENSE#(REOUIRFD): C(YIh-el.l'Yte4-7"Zdn CITY OFEVERETT BUSINESS LICENSE#(REQUIP,ED;: I(pCfj ; <br /> fr <br /> PRIMARY CONTACT: 0 OWNER lid CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: • a ' <br /> CONTACT PHONE: �� a,S 1 C�C) <br /> CONTACT EMAIL: � Jb le DC�YI vx_eGL�7f1C) .tc ry)Td241)13.w <br /> ; <br /> BUILDING PERMIT APPLICATION ( <br /> Existing Use of E3lllirllnq: Contract Price of Work: -- <br /> Proposod lJso of 13ullffinr): Heat Source: Gas OEleT.trio ❑Other 4 <br /> Building Typo: XSFR-Dotachod ❑SFR-Attached ❑Duplex ❑Multi-Family-ft of Units: <br /> 2_:__±__: <br /> meral ❑lr,Typo of Projocl: ❑Now ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler C molitiChng=•)`Us <br /> DESCRIPTION OF WORK: <br /> laS <br /> s <br /> i <br /> ASSOCIATED BUILDING PERMIT//(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of Pro)oct: Now _ Atkin Atkin Alteration Repair Type of Project: New Addn Alteration Re <br /> Yp ) pair <br /> #of List of Fixtures #of #of — i <br /> Fixtures Fixtures List of Fixtures #of List of Fixtures List of Fixtures <br /> Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump Toilet Backflow Freventer'I^s-_'e = -- <br /> Forcod Air Systems Unit Heater Bathtub Urinal J <br /> Gas Piping Boiler Lavatory(Wash Basin) Fount <br /> a-,Heater Drinking Foun.a <br /> r1 Refrigeration Shower Floor Drain — <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher <br /> Clothes Dryer Hookups Other: Roof Drains <br /> Range Hood Clothes Washer Medical Gas <br /> Water Heater Other <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water iNo.of Heads <br /> ACKNOWLEDGEMENT:1 hnvn rnvlownd this application and confirm the information contained berate is true and correct.Work done pursuant to this pe,,-.;.- . <br /> current federal,stale,and local law. Tho granting of a permit only authorizes approved work and no deviations therefrom Deviations must first be author zed,- >. <br /> f3uliding Official before timing authorizer)under any circumstance.I em the owner,or I am authorized by the owner of this property to perform the work for ii ;„; <br /> and I comply with the Stela Contractors Law 18.27 RCW and 296.200A WAG <br /> City cd Everett Official Use <br /> t, <br /> PO i.0 t JI'd,r" •1 f PEM�go2.Ownothorized A{inn gnature a� <br /> Dain (Revised 9/23/2015) <br />