Laserfiche WebLink
"IPPERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING I SIGN /SPRINKLER I DEMOLITION <br /> 01111111/7A- <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 or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:321 r - 0k /js• AV sr PROPERTY TAX#: QO f 650000c'p'Loo <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: ISAN C�V9-.GNSI5... TENANT NAME(If Commercial): EAcy ,.vim c_orjocs <br /> OWNER MAILING ADDRESS: STREET "2l\. Nc,ss- u .54 Q ,SK y <br /> '__ CITY r�•f(L I_e TT STATE w ZIP 2,0 I <br /> OWNER PHONE: C4ZS J ZS, - t 2 ( c‘ OWNER EMAIL: Fxia„n... (jnilk f+ C.ortcast , $E" <br /> CONTRACTOR NAME: BacsTiAcjeS CoyVtltitatlitS, <br /> CONTRACTOR ADDRESS: STREET 12,10 e?-,f opt_ L-10 ��'�f��(�`� <br /> CITY t V- jam ` STATE W ZIP fir\/ l J`/ <br /> CONTRACTOR PHONE: i17.5 .545/2515 CONTRACTOR EMAIL: 6. �jCDN'CQ.It 'Cf.51 l�fi WG- :CC <br /> CONTRACTOR LICENSE#(REQUIRED): Nb'T t-1/4CLW7A: 4, CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 53(} <br /> PRIMARY CONTACT: 0 OWNER *CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:°131--4 V.s`14,1 CONTACT PHONE: 105:N5161-5 <br /> CONTACT EMAIL:&NI agRC7T, (45cotApyfAoteejq OCAlkk.) '1: 46 <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: CON/pp Contract Price of Work:$ 15 K <br /> Proposed Use of Building: Heat Source: XGas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex XMulti-Family-#of Units: 4 ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> ge41/400e ANO ' litC-E ')(151.1/Q17 f120/J1- 1J1r►JcE--- / lf1.-S <br /> ? JO LAf 1pI j\J1?, • <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 /> 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 /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical 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 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 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> s::e...61.____ __, <br /> # <br /> -U1- 1 1112oi' - PERM en 01,,011 <br /> Owner/ uthorized Agent Signature Date (Revised 9/23/2016) \, <br />