Laserfiche WebLink
PERMIT, APPLICATION <br /> Imo'',IPP <br /> BUILDING/MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> .sitiw <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: Iv 03 at& %d � Ptx4e-1 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: CO/20 I'GO L.-L.-C.— . TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 23 i/n,3 4 gle- <br /> CITY J3 6 - STATE v'"/C7' ZIP 7 I 0 3 CO <br /> OWNER PHONE: Z' z�q zz�2 OWNER EMAIL: M0 ie jcOI`G) 4 1na1l , (.4144CONTRACTOR NA E: f — PI V`I/I Ii j A, ( ii)' ct py, ' l f�� <br /> CONTRACTOR ADDRESS: STREET ' �' <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#,(REQUIRED): �V� T �� CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)�'I`2,0 <br /> PRIMARY CONTACT: ,OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2.S 2h,et Z�Z_. f <br /> PA�C?I Li(ez % A-4.&Ri CONTACT EMAIL: /? 1 Jd(J waive I a.)`2 I(j <br /> r 1. <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: V4 C41-t)1 I & - ,Q- Contract Price of Work:$ Q • 00 <br /> Proposed Use of Building: $ A- Heat Source: f4Gas ❑Electric ❑Other <br /> Building Type: $ SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ORepair DTA. ❑Sign ❑Sprinkler ZDemolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> t f,{G t,'! A L -Trus CSS A 'VD PLA cE v4 rr--1-I /'-e‘,"4 O nl A6 PA 1/2, <br /> _Sg (IDE AJ 1?, A raD f = i. A -- MAeg. `E,0(1/1 1) lee-- PA e . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ..c, PLA A-) 7 cwi✓-zo <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration X.Repair Type of Project: _New Addn _Alteration ARepair <br /> #of List of Fixtures #°f List of ' • es #°f List of Fixtures #°f - of Fixtures <br /> •ures Fixtures Fixt Fixtures <br /> NC—Air Handling Units - •ump .4 . : <°' ow Preventer(Inside Bldg) <br /> X • ced Air Systems V nit Heater ZC Bathtu• I rinal <br /> Gas "ng Boiler 3 Lavatory( 1 - :asin) Drinking Fountain <br /> /kJ Water H-- - Refrigeration , , Shower Floor Drain <br /> Gas Fireplace Wood Stove 1 ,g Kitchen Sink&Dispos- Grease Trap <br /> Gas Range y<' Ducting 4. Dishwasher Roof Drains <br /> Clothes P -r Hookups Other: Clothes Was •-•ical Gas <br /> Ra 'ood Water He- - Oth- . <br /> •eg, gust Fan ink—T.', ice/B- t •;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 I claw.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 befor eing a horized 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 with a State C tracto Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 150 '3-06 2PERM6# <br /> J' 049 <br /> Owner/'uthori ed Agent Signature Date (Revised 9/23/2016) 1 i\ <br />