Laserfiche WebLink
Apr 24 2018 01:44PM Washington WaI=Meaters 8663757454 pagt- <br /> PERMIT APPLICATION <br /> 41,77 <br /> BUILDING 1 MECHANICAL 1 PLUMBING I SIGN 1 SPRINKLER I DE •LITTON <br /> CITY OF EVERETT PERMIT SERV.CES <br /> 320 CEDAR STREET,EVERETT,WA 58201 <br /> (P)425-257-8810 I FAX 425-257-8857 i(E)everetteps@everettwa.gov i www.evereitwa.govipe mits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: /6/$. 3a1 Ar PROPERTY TAX#: 0 OA 1 0 am o/7O 0 <br /> LEGAL for new construction: short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> -y� �/� <br /> OWNER NAME: !r i T'fl/ /r"O/r}i TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET logo Ars-4 y <br /> CITY6/1-9.11,e7+ 1,014_ STATE z. q 26453 <br /> OWNER PHONE y2 f 2745-- 0 Ct13 I OWNER EMAIL: <br /> CONTRACTOR NAME: t/01494//Al 71.ir-i ,--TE H6-6-7-6-/e5 <br /> CONTRACTOR ADDRESS: STREET r7f S Z (((e - A-v. 56. -- PG 5Ux 612,6S/ <br /> CITY WtitHie) STATE twit SI qb U 5g <br /> CONTRACTOR PHONE: '/2 - D 3_ , CONTRACTOR EMAIL: A ' ' •sit'V G it, <br /> SCiiiJ!llO/rj <br /> CONTRACTOR LICENSE#(REQUIRED): 1,04-9417-4—Vie CITY OF EVERETT BUSINESS LICENSE#(REQ - I)): 06 991 <br /> PRIMARY CONTACT: ❑OWNER 4.CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAMES CONTACT PHONE: c(2 - ' 3 -ca 7/ <br /> 1 <br /> . v.i~ <br /> OLAH IS CONTACT EMAIL: (,(„W-'G+.I4-fit.I'�C.@ Eu/}'L, •00.1 <br /> BUILDING PERMIT APPLICATION <br /> Existin•Use of B tildlne: .r ; ! .mit, Contract Price of Work:$ <br /> Proposed Use of 3uilding: Heat Source: ❑Gas r,'lectric 0 Other <br /> Building Type: DSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industr <br /> Type of Project: New ©Addition ❑Remodel DRepair all. ❑Sign ❑Sprinkler ❑Demolition OChange if Use <br /> DESCRIPTION t WORK: ��JJ <br /> R&mo pt &pl I �! e iL - lea ) <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICAT;+N/ <br /> Type of Project: _New— Addr <br /> n _Alteration _Repair Type of Project: _New Addn Alteration `Repair-- <br /> #of #of ' <br /> Fixtures List of Fixtures Ffx#ures List of Fixtures Fixfu es List of Fixtures Fixtures Li of Fixtures <br /> WC—Air Handling Units Heat Pump Toilet Backflow P :venter(Inside Bldg) <br /> Forced lir Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fo tarn <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 /> Range Mood t Water Heater Other: <br /> Exhaus:Fan Sink(Service/Bar/Mopietc.)_ Other: <br /> • SPRINKLER I SUPPRESSION SYSTEM <br /> 1 Numl+or of Heads <br /> ACKNOWLEDGEMMBVT:I have reviewed this application end confirm the Information contained herein is true and ccrrect.Work done pursuant to this pe it must comply with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviallons therefrom.Deviations must first be euthoriz d in writing from the <br /> Building Official before being authorized under any circumstance,I am the owner,or 1 am authorized by the owner of this property to perform the work for ich application is made, <br /> sokfi einply with the State Contractors Law 18.27 RCW nd 296.200,4 WAC. <br /> � <br /> �_,t� City of Everett Officia Use Only <br /> LJIIIJI 1÷(—74?', <br /> PERMIT \%c g ri a i <br /> -darner/Authorized Agent Signature Date (Revised 5/20//20`16) 1 <br />