Laserfiche WebLink
0 5/0 1/2 01 8 TUE 7: 02 FAX 425 415 6867 Feet water Heater UO 04/005 <br /> • PERDiIIT APPUICATKIt1 SI , <br /> r BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER I DEMOLITION <br /> CITY OF EVERETT'PERMIT SERVICES <br /> 1" 3200 CEDAR STREET,EVERETT,WA 98204 <br /> (P)425-257-B810 I FAX 425-257-8e57 I(E)averettepsoavar tlwo.gov I www.evereitwa-gov/permits <br /> JBiue er Black Ink OnI Please PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: aralignignir I 1PC p '' PROPERTY TAX#: 07I i I ' /II,L„/ Ai) V <br /> LEGAL for new conetruction: Short Plat/eubdivIelon Lot No, . (attach copy of long legal deecriptian) <br /> CONTACT INFORMATION <br /> OWNER NAME: j LSA” 1Y14 I,11L,.. TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: erRearE el,� Pe <br /> onY ` - tirbfr. srnre LA- - zia 96 DO3 <br /> OWNER PHONE: / fr p�° OWNER EMAIL: —' <br /> CONTRACTOR NAME: f ST 1n IAN V .kg. N( Ate ..g. <br /> CONTRACTOR ADDRESS: STREET 1 r l� ift..,L S <br /> / W/0 <br /> GUY II o M" 1�-1.— STRIE ZIP.. 1 5/t1 <br /> ! <br /> CONTRACTOR PHONE: (--'15". I4 ‘.P 31" CONTRACTOR EMAIL;re 1Z,VY1 fl'SP-FA.s /v�� /YAnA-vJD1�f,I��GL�ir. 1 t5Vii <br /> CONTRACTOR LICENSE#(REQUIRED):VASTWVO }cj 13(_... [CITY or EVERETr BUSINESS LICENSEii(REQUIRED) •C153 <br /> PRIMARY CONTACT: IZI OWNER VI CONTRACTOR O OTHER(Please Specify) <br /> • CONTACT NAME: CONTACT PHONE: 1-1 a-5- / ' <br /> KA:vli ' -' -\4t/ CONTACT EMAIL: yt/1:►" S • _ I/L1d4fi{,-kU•'. . w <br /> BUILDING PERMIT APPLICATION <br /> Existin• Use of Bulldin•: • Contract Price of Work:$ r5.��_7z= * <br /> Proposed Use of Building: 5 rr� Heat Source; ❑Electric CEOther <br /> . Building Type: *SFR-Detached EISFR Attached UDuple_x_ QMultt-Famlly�of Units:_. . DCommerclel C]indu_strial <br /> Type of Project: ❑Naw DAddition ORemodel l Repair CIT.!. OSign OSprinkler ODemolltion ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> 6/2)--S LA)a-A-eir \n. coc-t- <br /> ASSOCIATED BUILDING PERMIT# if ap.Ilcable: <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Prajectt New_ Addn _Alteration _Repair Typo of Project: Now- _Addn _Alteration ,Repair <br /> #of <br /> Fixtures 41st'of Fixtures V of Fixtures list of Fixtures Flxrures 1-let of Fixtu -_ _ List of Fixtures <br /> AIC-Air Handling Units Nest Pump Toilet Backllow Preventer(Inside Bldg) <br /> • Forced Alr Systema Unit Heater Bathtub Urinal <br /> ` Gas PI In Zoller Lavato lij5=1 Drinkiri. Fountain <br /> I Water Heater Refdteratlon Shower Floor Drain <br /> Gas Fireplace _ 'Wood Stove I(itchen Ink&Disposal Grease Trap <br /> Gas Range DuctIng Diehwash= _ Roof Drains <br /> Clothes Dtyer Hookups _. T Other: Clothes Was .r _ Medical Gas <br /> Range Hood Water Hee:_46_ ,Other: <br /> Exhaust Fan Sink .. +ce/Ear/Mo• - . . Other: _ <br /> SPES8lo Sverelvi - .. <br /> RINiL <br /> rt ismical or W - ,of Heads <br /> ACKNOWLEDOeMENr•l have reviewed this epplloallon and confirm theme lnlbrmal/on contained herein/s true and correct,Work done pursuant to this permit must comply with <br /> current federal,stale,end local low,The grenfing vi a permit only authorizes approved wort(and no deviations tlrarehom.Deviations must first be euthoriked in writing from the <br /> Building Official bolero being authorized under any circumstance.I em the owner,or I em authorized by the owner of ibis property to perform the work for which application Is made„ <br /> and i comply with the Slate Contractors Law 18[27 ROW Sad 208.200A WAC <br /> City of Everett OPAclel Use Only <br /> ���, ,.i• , ,� s� 1-, $ ' QS_ cow[ <br /> Own<' •other zo,Ag= Signature Date 'Revised 9/2t ) <br />