Laserfiche WebLink
• <br /> PERMIT APPLICATION <br /> BUILDING i MECHANICAL./PLUMBING/SIGN I SPRINKLER/DEMOLITION • <br /> T c)-/Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everetfwa.gov/permits . <br /> a(ui®'®>r)BIak►fin :a;.fihrefe s®) ' : .1PROJffdr Slat 111 C: in 'Iolt1 .. • . <br /> I <br /> PROJECT SITE ADDRESS: 4 — '2ji'lay% IZ PROPERTY TAXA I <br /> LEGAL.for new construction: Short Flat/subdivision Lot No. (attach copy of Tong legal description) <br /> . . .. .COk�YTAdT PO N T I Ot''I -- -, <br /> OWNER NAME: .,-:` ,Zy 1ja-el IAA r..J0�J(. If TENANT NAME(if Commercial): <br /> OWNER MAiLiNGADDRESS: t STREET t-�(•'?Z 7 (1�a(Zl/.'Lo►�'r b(Z _ • <br /> I ` CITY .VL STATE 1...4-5A ZIP �c 2 0 3 <br /> 'OWNER PHONE:(�ZcJ k7r7 — 1QC(1 OWNER EMAIL:- 1y),SS A L A'GAOI , t Cmi,...-.r <br /> CONTRACTOR NAME: {UOR.C4. AJ '?7 6 Tf: �fiC'e - <br /> CONTRACTOR ADDRESS: STREET .--(2- {ef-C-t AU ti p� <br /> E,,, 'rte Ur2 6 STATE (, I l4- ZIP 6t�7° / <br /> CONTRACTOR PHONE: 4'2,5-,2.c a.-3//ti • CONTRACTOR EMAiL: J 61 <S Q XL Uu <br /> CONTRACTOR LICENSE#(REQUIRED): C `Q. 4S&2. -r CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): &j r ';' '• <br /> PRIMARY CONTACT: °OWNER ONTRACTOR °OTHER(Please Specify) <br /> CONTACT N Es CONTACT PHONE: 4 7 5-2.5-2-50 <br /> _ bOttr JNG-P Rl1 JTAPPLICATI®[d'• • . . •- . . <br /> Existing Use of Building: 1 Contract Price of Work:$ <br /> Proposed Use of Building: Heat Source: WiGas °Electric °Other <br /> Building Type: R Detached CISFR-Attached ODuplex °Muiti-Famliy-#of Units: °Commercial Qlndusfrial <br /> Type of Project: °New °Addition Remodel °Repair i Ti. °Sign °Sprinkler °Demolition °Change of Use <br /> DESCRIPTION OP WORK: Il *G. h -- i[24.Qs4G. 4 ti'6 Add i i Al fa_ <br /> t!10 VJ i k'"f 0 t,..? • <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> IV114-C6 AIkllGAl IfVkeiI9 'APP►lid'A Tal • . PILUM69ING OE I1$APPILiIGATI1',f•Y ; <br /> Type of Project: New Addn Alteration Repair Type of Project: New Addn Alteration •_Repair <br /> #°f 1 List of Fixtures #°f <br /> FixtuList of Fixtures .' #°f List of Fixtures #°f List of Fixtures <br /> �es Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units ! Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> 1 Forced Air Systems , Unit Heater Bathtub 1 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 Wafer Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.), Other: <br /> : :.e1111I6YYft;LEtk/ ,OPP1;3OI®NY•s mTEM • ' ! <br /> !Number of Heads <br /> .CKNOWLEDGEMENT:/have reviewed this application and confirm the information contained herein Is true and correct.Work done pursuant to this permit must comply with <br /> urrent federal,state,end local law.The granting of a permit only authorizes approved work and nc deviations therefrom.Deviations must first be authorized In writing from the <br /> ullding Official before being authorized under any circumstance.lam the owner,ori am authorized by the owner of this properly to perform the work for which application Is made, <br /> and/comply with the State Contractors Law 18.27RCW and 296.200A WAC, <br /> Oily ofEverett Official Use Only <br /> PER i # <br /> l <br /> y7-Li --1 \. 0t00- en( <br /> vner/Authofixed Agent Signature Date (Revised 5/20/2018) <br /> II <br />