Laserfiche WebLink
PERMIT APPLICATION .�■■ <br /> /— BUILDIN�) MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> ' 3 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 /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 34y/if A/0 R 770 Al 4--VE 'PROPERTY TAX#: 001.33_75R2 702300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Apt// EA/'6 / ,AJ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREer 3'y/J( ,4J /) ,4-)( <br /> CITY E'i/i/Z, ^ n STATE �,^�/Vd� ZIP 9R)2/ <br /> OWNER PHONE: 'J/2S. o75g ' <br /> -12 7 OWNER EMAIL: �DR/�.l,/ito &j.,,, ,etj/rf <br /> CONTRACTOR NAME: /2671/€' e -y7 C/aL. Lb.e <br /> CONTRACTOR ADDRESS: STREET //43t !) 2 ‘'/�/l .417/C SE <br /> CITY h7/ //��/.�/\ <br /> // C../Gr. STATE h$ ZIP WO/2 <br /> CONTRACTOR PHONE: a70Fj 7/9- 65e,Z CONTRACTOR EMAIL: /y7/Jj,¢,2-tAlfie i 4. 1 �: <br /> CONTRACTOR LICENSE#(REQUIRED):,9af/FCCL cP1Z 0 W CITY OF EVERETT BUSINESS LICENSE#(REQUI' I <br /> PRIMARY CONTACT: ❑OWNER :CONTRACTOR 0 OTHER(Please Specify) ,. <br /> CONTACT NAME: CONTACT PHONE: t, ,v9.-‘56z <br /> 7/e -09 E i(6902.. CONTACT EMAIL:wiejazt Kea a ore CJArk,,oz-7 <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: -Kea;P274+4 L.. ..Z-' Contract Price of Wo $ 0-0 r . <br /> Proposed Use of Building: t Heat Source: ❑Gas m lectric ■ It er <br /> Building Type: ®SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial <br /> Type of Project: ❑New ❑Addition FB emodel ORepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: .,,L .e.:,..45,,,, Sub FiG 11 ;,.... $&tch. 'r►'t_ 1 g7w of 1 F']eriS'#'1••.1 <br /> z544hRAtn,A RKd L,.4.t.,79 <br /> ASSOCIATED BUILDING PERMIT#(if applicable)::: <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New Addn _Alteration _Repair <br /> #of List of Fixtures list of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump / Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler 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 oZ Sink(Service/Bar/Mop/etc.) Other. <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> 'Chemical or Water ' 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 lam authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> i/_�i��el�, / PE T \ 2-03 ` O ) . <br /> •"^"':"/A. Date (Revised 9/23/2016) <br />