Laserfiche WebLink
"1111.d'--i <br /> PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING I SIGN/ SPRINKLER/DEMOLITION <br /> 1 CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 ((E)$verettepstaverattwa.gov) www.everettwa.gov/permits <br /> (Blue or Ellack.lsfik`Onl�Please)--..� � 'PRt3JSGT6ITttINPtAiV17Ii CION re_ „t.W'*� P <br /> PROJECT SITE ADDRESS: s t 2. klfpt Sr '�`�t <br /> LEGAL for new construction: Short Plab'subtiivislon j"'14"' PROPERTY TAX#:Lot No.. (attach copy of long legal description) <br /> ' `CONTACT IN# RMATi N ., x . ,. e' <br /> OWNER NAME: + <br /> TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> ciry <br /> STATE ZIP p 4 <br /> OWNER PHONE: # 05k D3 OWNER EMAIL; <br /> CONTRACTOR NAME: . 'S in t11 C <br /> CONTRACTOR ADDRESS: STREET t`S ^ <br /> octxtui c)-9. <br /> CTY iii, • j <br /> STATE A ziP . 1 ) <br /> CONTRACTOR PHONE: <br /> 2.5 Zrja 0 0 CONTRACTOR EIVIAIL( p i c,vv, t • Ifl .CCT <br /> CONTRACTOR LiCEN,SEREG3UltiEDit . ,; s ..pts 0 _. CtTY-O VERETT-BUstNESStICEN1SE#(REQU''IRED <br /> PRIMARY CONTACT: D OWNER ) � ��-- <br /> IYCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: <br /> D^1^ CONTACT PHONE: t .2.6 2CJ. t' (:) 97. ) <br /> 1CiCJ N^ LL <br /> CONTACT EMAIL: t <br /> ..�r • Lk feta.. # .Co <br /> ,; .4SUILCilhlaVO l'l;MatiAl*41 q �l16 x' `'44, `, ;. .- r <br /> Existin..Use of 8utldln. ESITEMMIC: <br /> Pit?:os$d Use of H -Ing: PMIIIIIMIIIIMIIIMII <br /> i <br /> Heat Source: ','Sas ❑Electric ❑Other <br /> Building`Type: Detached ❑SFR-Attached <br /> ODusia� ❑Multi-Farrlil of nits <br /> ❑Commercial Olndustrial <br /> Type of Project, ❑New ❑Addition ©Remodel OR9aatr OT.I. OSisn DSprinkier ❑Demolition OChanee of Use <br /> DESCRIPTION OF WORK: <br /> ASSOCIATED BUILDING PERMIT#(if aepticable'3 <br /> MECHANICAL-PERMIT.,AP, CLIC%'TJON y <br /> Type of Project: _New ,�. Addn ., ;���l��r)����/'GIIIi��y;���lil�`r�Tl�l� <br /> Alteration Repair Type of Project: New <br /> At of #bf _Addn Alteration Repair <br /> t�f�rt Of Fsjr#of l let ra{>etxturax- #of #of <br /> MIIIII - i='i___ - -Gia_ fiiytt�rer <br /> NC–Air Handling Units Fixtures s .__ <br /> —�}sf fit��ttrr� <br /> IMO /teat Pump Crsliet <br /> Mal Forced Air Systems Unit Heater Lint Backflow Preventer Imide 131c <br /> Gas Piping Bathtub Urinal <br /> - a- �Boiler Lavatory(Wash Basin) <br /> .Gas Fire.laceRefrigeration Shower Qrinitin Fountain <br /> Wood Stove Kfichen InR #7i pos I Floor Drain <br /> Gas Range Grease Tia <br /> ClothesNM a Dr er Hookups Dustin Dishwasher <br /> Other: Clothes Washer Roof Laraine <br /> Ran*e Hood Medical Gas <br /> W " plater Heater Other: <br /> Sink{ServjcelBarJMIINIMMIIIIIIIIIIINMIIIIIIIINIIIMo Pete. Other: <br /> M;'SPRINKLER:-/SUPPRESSION SYSTEM <br /> Chemical or Water <br /> No.of Heads <br /> ACKNOWLEDGEMENT'I have reviewed this application and conr7rm me information contained herein is true and correct.Work done pursuant to this permit must c <br /> current federal,stale,and local law. The granting of a permit only authorizes approvedompiy with <br /> lidding(Mora, beingunderany work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> circumstance.t 00 the owner,or t am authorized by the owner of this property to perform the work for which application is mace, <br /> and t comply with the StaiContractorsorizeLaw 18.27 ci cu and 296.200A w, <br /> WA <br /> City of Everett Official Use Only. <br /> Alt PERMIT# _ , <br /> Ow,sr/Authorized111Ua,- $ i�' 0 - t /vr C(1 <br /> Signature ' <br /> Dale ' (Ftevrsad 9f2.3I71:116) <br />