Laserfiche WebLink
al PERMIT APPUICATIIC _ <br /> BUILDINS kiECHANICAL I PLUMBING 9 SIGIt1PRI KLER I DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 i <br /> WASHINGTON (P)425-257-8810 j FAX 425-257-8857 j(E)everetteps@everettwa.gov j www.everettwa.govtpermits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION f <br /> PROJECT SITE A€DRESS: u 0. 1 ', ST eve,--e f i ! 0 !PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot Na. (attach copy of long legal description) <br /> CONTACT INFORMATION ________A, <br /> OWNER NAME: 47,097-7j\1 e ,_c(d ni r e-L L TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 0 OP 'l` t 1 <br /> CITY s/I 0 A Z7ro 1 s h STATE �,/4 /} .ZIP ' 9()1OWNER PHONE: f e2 3/9 7.5<, - OWNER EMAIL: (kis h(.�G e e t°' �f�'A Do, (c,M <br /> CONTRACTOR NAME: g C'v A — <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> a <br /> !CONTRACTOR PHONE: 'CONTRACTOR EMAIL: <br /> 'CONTRACTOR LICENSE#(REQUIRED): 'CITY OF EVERETT BUSINESS UCENSE#(REQUIRED): <br /> 'PRIMARY CONTACTWNER E'CONTRACTOR Li OTHER(Please Specify) <br /> !CONTACT NAME: 'CONTACT PHONE: q�S' 31 9 736-2 <br /> i r r/NI d7', // i�i A EMAIL: etr� fJ ,ce_ "�'" j�A'406. (.70 ii, <br /> 1 L <br /> EUII IPI[] INFORMATION a <br /> d sting Use.,Bu------_ ---,_. il"d ng: !Con race Price of Work:$ 3,..s-DO 6 <br /> 'Proposed Use of Building: ,Heat Source: ['Gas DElectric DOther <br /> 'BUILDING US' rA SFR []Townhouse []Duplex ❑ADU ❑Multi-Family-#Units: .__-.. ❑Commercial DAccessory Structure_ g+ <br /> jype of Project: 'New LAddition ❑Remodel []Repair DT.i. []Sign []Sprinkler []Demolition DChange of Use <br /> DESCRIPTION OF WORK: <br /> 1 `Te 4-r 621 I- l /1sy-)4' )1 IRC>16' ` s 1"j le--5 i <br /> "ASSOCIATED BUILDING PERMIT#(if applicable): <br /> : MECHANICAL PERMIT APPLICATION PLUMBING BING P IT PU TIO 9 <br /> Fixture ! �txture Fixture I Frere I <br /> 4 List of Fixtures List of Futures ,List Of Ffxtrares list of Fixtures <br /> 1 Count I comm , Count Coutrt <br /> I INC—Air Handling Units I !Gas Piping I f BackfIow Presenter(Inside Bldg) I !Shower,Tub,or Combo <br /> Boiler Gas Range ( Clothes Washer 1 'Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless I 'Dishwasher "Sink Residential(kiichen,bath,bar) <br /> E Duct System(Remodel) Refrigeration g €3 inking Fountain <br /> Sink-Utility,laundry,mop <br /> 4. !Exhaust Fans(Residential)g !Commercial Ventilatiorr !Floor Drain 1 ProNet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) I Water Heater 'Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential)! Wood eve I linterceptor-SandlOil I 'Water Service(behind meter) I, <br /> r€ 1Fcrced Air Systems a< --filter: 'Medical Gas _ !Water Valves or Fixtures <br /> I !Gas Fireplacellnsert/Log I I 'Roof Drains Water Heater <br /> I <br /> SPRINKLER/SUPPRESSION SYSTEM !Sewage Ejector or Sump Pump Other: <br /> Water Suppression System I iNo.of Heads I i i <br /> Chemical Suppression System INo•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 /> Sur"ldog Official before lei authorized under any circumstance.lam the owner,or lam authorized by the owner of this properly 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 /> riP1 PERM! I <br /> /,�� g i(/// 0201 I ���C0(0. ,)�� 1 <br /> O erlAuthorized Agent Signature Date (Revised 10/1012018) <br />