Laserfiche WebLink
PERMIT APPLICAT1011111 <br /> BUILDINJ I-''''IECHANICAL/PLUMBING/SIGNRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 l FAX 425-257-8857 1(E)everetteps©everettwa.gov l www.everettwa.gov/permits <br /> (Blue ar Blla+ch>ik Only`Please) P;ROJECT.SITE INFORMATION <br /> PROJECT SITE ADDRESS: E Evert MG►,l( (,.)(u smile ,D PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • CONTACT INFORMATION <br /> OWNER NAME: SIS wet,' TENANT NAME(If Commercial): t 1u&o4- Pltiaw� <br /> OWNER MAILING ADDRESS: STREET 2..010 I5(pt"' Awe" me- inw.+G pa * 45/./. Car <br /> l am�a`a,�.r►a se� <br /> CITY 6.(�ttt.VKL STATE VJ Pt ZIP e�00� �.. <br /> OWNER PHONE: IVA-- L4SS-- tq.SI OWNER EMAIL: app-Iric -b Ao <br /> S%A rc ,cvw� <br /> CONTRACTOR NAME: Pkrt.l;�„ (�Go LA. <br /> CONTRACTOR ADDRESS: STREET 11 C I( I R 14- 64-te tut <br /> I ' A <br /> CfY Se t,A STATE W A- zIP trizr <br /> CONTRACTOR PHONE: ZD(o 0,04nli ��( 0 Yt, �0't�:TOR EMAIL: �re.{%�. Neov,f q J ,iw tI co w" <br /> r`^ Tq" ,t`cRw2 <br /> CONTRACTOR LICENSE#(REQUIRED) Fz�,EFN - >�foci CITY OF EVERETT BUSINESS LICENSE#(REQUI ed <br /> PRIMARY CONTACT: 0 OWNER I C�.e, <br /> ONTRACTOR 0 OTHER(Please Specify) fj� ! ,;. <br /> CONTACT NAME: •� CONTACT PHONE: 2,0&. 6,50 (L 7 !G a..44._ <br /> k0`V�" u�__,A�,�''/1S CONTACT EMAIL: /ti���yve.aVlQ,4 ttAGtt •Cow. <br /> BUILDING PERMIT;APPLIICATIOf�1 <br /> Existing Use of Building: Contract Price of Work:$ 4.5 O D- DO <br /> Proposed Use of Building: Heat Source: OGas DElectric ❑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. OSign OSprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: �5+ ,moo (2-• 1 IL A C,,wµe( (e,H-GK Cs fil,\- <br /> (914k0 S-k rt. A3c- wt.-1,1s . ( 2.04. — O2g <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION ; ., ; <br /> ' Pla`JFM®liNr3'I+EI~#M,t'i",A�►P4f11:9�"'l+ak�l;` ,. _. . <br /> Type of Project: _New Addn Alteration _Repair Type of Project: _New Addn teration Repair <br /> #ofList of Fixtures #of List of Fixtures #of List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures xtures <br /> A/C-Air Handling Units Heat P p Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Was asin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen nk&Disposal Grease Trap <br /> Gas Range Ducting Dis asher Roof Drains <br /> Clothes Dryer Ho. .. Other: othes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust F. Sink(Service/Bar/Mop/etc.) Other: <br /> :,LER/:;SUPPRESSION SYSTEM;;, <br /> hemical or Water ' ko.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 I em 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 /> g/7/19 PERMIT#5 ( SO D03 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />