Laserfiche WebLink
PERMIT APPLICATIO ', <br /> BUILDINWLhECHANICAL/PLUMBING/SIGI I RINKLER/DEMOLITION <br /> OLT <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 /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: <br /> 3toc9 vrpcuW <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): fbcj-f.. -Fouler- a-t-krleS <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: 86 if- Sa9y, SerVICCS <br /> CONTRACTOR ADDRESS: STREET /bpa)a �'JC7The i-E Vere -141AJ y -1:7;a31 /� <br /> CITY I f 1 G"eeK STATE W A-' ZIP Ctf30)o'Z <br /> CONTRACTOR PHONE: 1,;25, 330,e,'too {CONTRACTOR EMAIL: bbf- s 19Il s YYl s r .Ccs <br /> CONTRACTOR LICENSE#(REQUIRED): OSTS I Sig 9 0 r-La( CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):Q 55 I U 9 <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2� 33.3 1/ 6 <br /> LD <br /> ralnK 60 zeiCONTACT EMAIL: <br /> /..7.,7--r---4,,,4- 041✓it . Com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: CC)Yr]N1,YC a_ Contract Price of Work:$ 60 a CI 0 _ <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other _ <br /> Building Type: ❑SFR-Detached ❑SFR Attached ❑Duplex ❑Multi-Family#of Units: >Commercial 0 Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.L ,ign OSprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> in5to1/411 CI) r10Yt-iituy'riina4ea mei-al .toctUUsigh — 242 j OI' oovhi -fAtt/A-tidl‘, <br /> I'nS-traCI CI) LED me sags cefl-e.r 15 ,y cii _ on. Soi.t lA k+'-- <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 /> • <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number 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.lam the owner,or!am 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 /> t /q f g PERMIT r .p \-' co\ 0 <br /> Own /Au Agent Signature [7 ate `, (Revised 10/12/2015) / <br /> IZ <br />