Laserfiche WebLink
PERMIT APPLICATION <br /> #111:—A <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> '1dV <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION / <br /> PROJECT SITE ADDRESS: L�1 f�'�#f ,--4—I00 PROPERTY TAX#: y 59/ bZ/o l 7OG <br /> LEGAL for new construction: Short Plat/subdivision :11" Ci.'1 /L'A of No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: /V nit(/ Fil/(�` j � L -' TENANT BUSINESS NAME(Commercial): ilikt 10Q(A- <br /> OWNER MAILING ADDRESS: STREET re)(41-.5 t974. <br /> 136i_ // <br /> CITY � ,�� STATE ZIP 9e <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: SECURITY SIGNS, INC <br /> CONTRACTOR ADDRESS: STREET 2424 SE HOLGATE BLVD <br /> CITY PORTLAND STATE OR ZIP 97202 <br /> CONTRACTOR PHONE: 503-232-4172 CONTRACTOR EMAIL: permits©securitysigns.com <br /> CONTRACTOR LICENSE#(REQUIRED): SECURSIO2OCF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): in process <br /> PRIMARY CONTACT: ❑OWNER(1" I] CONT )bR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 503.546.7102 <br /> CYNDI STOCKS CONTACT EMAIL: permits@securitysigns.com <br /> BUILDING INFORMATION <br /> r vL. <br /> Existing Use of Building: /'/VF1 NC-M''L /0E--7,-e. Contract Price of Work:$ Zf 7 7 0 . <br /> Proposed Use of Building: r/ Heat Source: OGas ❑Electric DOther <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Famil - • its: 'aCommercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ETA. ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: /N 7 -LL (, \ /Z-4-12/21/N�- � / / � 5/4 ,v <br /> DA/ $�} )7 2+ EJ x.77' @� /T6�c✓ [.[5�/ ( rJ D <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain _Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) ,Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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.I am 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 <br /> Only D-2�d 4 f PERMIT# 0\ ,( <br /> Owner/A orized Agent Signature Date (Revised 10/10/2018) <br /> II1/1 <br />