Laserfiche WebLink
BUILDINECHANICAL/PLUMBING /SIG ' RINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERV <br /> 3200 CEDAR STREET,EVERETT,W _ <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please)'' PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 0- 1 a, ?(AZ 46 '1- PROPERTY TAX#: od (6.4 $02-7vp <br /> LEGAL for new construction: Short Plat/subdivision pi tN003CYP°N NO Lot 141(efilttach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: r,,Ot•$ err (-fer TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET zip?) piiv 5 i <br /> CrrY gve-t+r+.�G r- STATE ZIP 2 0` <br /> OWNER PHONE: 442.6- fjl V 13?j`I OWNER EMAIL:/D(5 j IA R5'VA;C ecol4CGtg .64+Q-f <br /> CONTRACTOR NAME: 1/1A-/CFCCQt\SSTg_UC`-C CJ LAIC +Nc (JT-'cZ o5O <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: r 7'7C). 643 73 CONTRACTOR EMAIL:ert'C-e. At:ix.cercedul'trim- r r'''" <br /> CONTRACTOR LICENSE#(REQUIRED): ►'AXFICL-61'211'K cf CITY OF EVERETT BUSINESS LICENSE#(REQUI-ill vlip v,d, 9 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ,j OTHER(Please Specify) CI-t I Z'ce C'r <br /> CONTACT NAME: CONTACT PHONE: !yr, 442, /3,5b <br /> djUC'N to ax/ CONTACT EMAIL: <br /> l BUILDING PERMIT APPLICATION <br /> Existing Use of Building: l` t� i OCKN (A -- Contract Price of Work:$ A t aC-Nc!) <br /> Proposed Use of Building: ( e5«9 t_r.r l i/t c.-. Heat Source: ❑Gas ' lectric 00th- <br /> Building Type: , SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: 0C.,. ercial ❑industrial <br /> Type of Project: ❑New ,I Addition ❑Remodel ❑Repair DT.I. ❑Sign ❑Sprinkler ODemolition ❑Change of Use <br /> DESCRIPTION OF WORK: ,lap rL„ci p f rt.6,U (4-i 5-j ajpRmek ( krill <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New ,4 Addn _Alteration _Repair Type of Project: New ,j .Addn Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures # List of Fixtures <br /> Fixtures Fixtures Fixtures Fbctures <br /> NC-Air Handling Units' Heat Pump / Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Z 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 /> Range Hood Water Heater Other: <br /> ( Exhaust Fan Sink(Service/Bar/Mop/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 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 I 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 /> IPF,IRMIT# <br /> CI---k( 0 [ — 01 ,0 (!, <br />