Laserfiche WebLink
46-77PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <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:6/7/Z l s/ PROPERTY TAX#: co 87 67 6,0000/S0 a <br /> LEGAL for new construction: ShortPlat/subdivision/-74I/41-8f2G ,K Lot No./5' (attach copy of long legal description) <br /> CONTACT INFORMATION; <br /> OWNER NAME: RJ/4A.( / , '/7'7-' TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> �r?0 y/Z /. LA-)/)R, / ��� <br /> CITy' <br /> Y /�V eNQ I�/ STATE (�tJ�' zip 90 e)0 3 <br /> OWNER PHONE: 3 — VC,/- 3 2 q y OWNER EMAIL: <br /> CONTRACTOR NAME: OGL1Pir2 7OtT'•/Y (ALU j/i.P&a ?J 1 i(/• <br /> CONTRACTOR ADDRESS: STREET V <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): t((�� <br /> tT 1 <br /> PRIMARY CONTACT: D OWNER 0 CONTRACTOR AiOTHER(Please Specify) Q..r9i( v 19'-r /04-0/5W/_",,,g-/-v <br /> CONTA NAME: CONTACT PHONE: s <br /> CONTACT EMAIL: egja.t5a.99/ho,` d e -s @ 6-HCl, �t € <br /> i„ BUILDINd:PERMIT,APPLICATION <br /> Existing Use of Building: 5"P Contract Price of Work:$ <br /> Proposed Use of Building: /21i C-rzczy - r Illi An° - Heat Source: AtGas U Electric DOther <br /> Building Type: DSFR-Detached DSFR-Attached DDuplex OMulti-Family-#of Units: ❑Cummer Dlndustrial <br /> Type of Project ❑New RAddition OrRemodel DRepair DT.L DSign DSprinkler D'••••itio! i Change of Use <br /> DESCRIPTION OF WORK: <br /> 60°O,D <br /> PAltalir /9-0,4/770A.J <br /> u/J r1<�uf�� 7' .�K�s-T"��G �vscF F-0/1- /21E-C. 2�t <br /> ! X/0�-NTLo�• <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> ",;.;.g MECIHINICAL HERMIT APPLICATION.:,,, ,;r PLUMBING PERMIT,APPLICATION. „ ;;, ,,.„, ^ <br /> Type of Project: _New _ Addn Alteration _Repair Type of Project: New Addn Alteration Repair <br /> #ofList of Fixtures #°f List of Fixtures #°f List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) 1 <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> X' Gas Piping _ _Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> 'X Gas Fireplace Wood Stove X Kitchen Sink&Disposal • Grease Trap <br /> X Gas Range Ducting >c Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> XC Range Hood Water Heater Other: <br /> XC Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> ,h SPRI,N_KLER/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.I am the owner,or I am authorized by the owner of this properly to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAG <br /> City of Everett Official Use Only <br /> PERMI <br /> j q.r) s <br /> O ner utho!zed Agent Signature Date (Revised 10/12/2015) <br /> 41111 <br />