Laserfiche WebLink
PERMIT <br /> APPLICATIO <br /> BUILDING / MECHANICAL!PLUMBING I SIGN <br /> N/SPRINKLER I 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)everetteas everettvaa.gov I www everettwa.gov/permits <br /> jakte orBiaok ink:onty Please} . ,PR --wC7 rEw1F£1Ft�1111�`1' i. <br /> PROJECT SITE ADDRESS. '+ir J `�-e j <br /> t 1c PROPERTY TAX It: <br /> LEGAL for new construction: Short PlaUsubdivis on <br /> Lot No.• (attach copy of long legal descriptlon) ;' <br /> OWNER NAME° , 1` <br /> CONTACT INFORMATION - <br /> itit 1 d �t TENANT NAME(if Commercial); <br /> OWNER MAILING ADDRESS: s'RE - s ' tR <br /> .-:Ty <br /> --•-- �,^ <br /> OWNER PHONE: o r + I STATE t . <br /> j�, OWNER EMAIL: <br /> CONTRACTOR NAME: _ �, ,t 1 n Y1 C <br /> CONTRACTOR ADDRESS: sr:eEsr IL-171 <br /> t� �di <br /> CITY law I.a i� . <br /> CONTRACTOR PHONE: sTATe nF c <br /> CONTRACTOR EMAIL.?Al 4 ‘ <L <br /> _-- r�Tr�a�xa� �NsE�REQ+��Es):. �` '.- ..11.�, ane ,,�+�G'7�,jt <br /> PRIMARY CONTACT: C.1 OWNER <br /> coNTRACT � ��` _ `OtTYi9P` VER S`t`HUSIN!SSt 1C(NSE (RE <br /> OUIRED) V (3 _ .... <br /> OR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> T��_ F_ CONTACT PHONE: t„ .2.6 25c/ 0550 <br /> �xW,� CONTACT EMAIL: eJ� <br /> cs1,7'L , •Cip <br /> WILDINGPEIS{YIItAi4lititA loft-tre ,. <br /> Existing Use of Buiiding> <br /> ------ Contract Price of Work:$ -3 Qt' t <br /> ropcised Use of Sabin.: <br /> Heat Source: ❑Gas ❑Electric r her M Juli Mi~ <br /> Suiidin T pa: DSFR-Detached ❑SFR Attached DDuofe, ❑Multi-Famil 4of Units: <br /> Type of Project: ❑New ❑Addition ❑Rumodef ❑Re air I�1•l ❑Commercial Qlndustrial <br /> DESCRIPTION OF WORK:-" �-- -- P Sign1 tiler ❑pemolttion ©Chair: of Us <br /> U ‘5.\-- w00 c,- e -- <br /> ASOCIATED BUILDING PERMIT#(if applicable): <br /> MfiGHANIC/•"tL=1�EFtMI"t"APPLICATION � <br /> . - . _ ;RL''I,�tViBil+�iG'pEt�lltli''�'ir�tP�pfCAT1OEt <br /> I. #Of '' Type of Project: New Addn Alteration Repair <br /> _ <br /> _` ?txture " #of #of <br /> NM/VC-Air Harldiint Uni#s FixturesCist-of-Fixtures LieMaFFixttir <br /> Fixtures <br /> Forced Air Systems Toilet Beddow Preventer-Inside Bid.)Gas PipinMill Bathtub Urinal <br /> Moiler Lavatory Wash Basin <br /> �� ��Refrlgeration Floor <br /> ( r Fountain <br /> Gas Fireplace Shower Floor Drain <br /> MEN Gas irepWood Stove Kitchen Sink&Dls•csaj <br /> Clothes Dryer Hookupsmintammom Grease <br /> Other: Dishwasher Medical Gas <br /> 'Refire Hoed <br /> Clothes He Washer Medical Gas <br /> Water Heater Other: <br /> _� Sink(Service/Bar/Mc /etc.) Otleer. <br /> 11111101611•11.1.111.- SPRINKI ER'`l SUPPRESSION OON SYS T� E�� � <br /> anChemical or Water <br /> No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this applhticn and confirm the information contained herein is lme and correct.Werk done pursuant to this permit must comp <br /> current federal,state,and lace!law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized In writing <br /> h <br /> Building Official before being authorized under any circumstance.f am the owner,cr t am authorized by the owner alibis property Scperform the work for which an <br /> s' <br /> and I comply with the State Contractors Law 18.27 RC W and 296.200A WAC. from we <br /> F�lkatin is made, <br /> City of Everett Uncial Use Only <br /> . tQ 0 l FE-,. • <br /> Ow sr/Authorized Age tune 1� 1( , <br /> fl Signature <br /> 1 <br /> Date <br /> (Revised 5 3/201 <br />