Laserfiche WebLink
0 PERMIT APPLICATION <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY 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 i www.everettwe.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 306 Rock efe kq f <br />PROPERTY TAX #: <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME:Sh� /, }1 , j-( TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: STREET 3060OG�-e-(C I ey- V -,e q0 ' <br />CITY V Q►re STATE 21P <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: <br />-Cy 0yt vvV ✓L <br />CONTRACTOR ADDRESS: STREET Ii 22) 7tn d A-V'e tiJ <br />CITY `CQ �- STATE Wvt zip 3Z <br />CONTRACTOR PHONE: O(p' ��32�3 <br />CONTRACTOR EMAIL: �L �Q n -e ��yv�Gh �SU�- GU ✓I� <br />CONTRACTOR LICENSE #(REQUIRED): Q <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): (53 Z 6 2 <br />PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />y_\ <br />CONTACT PHONE: 'Z o (p - �5 %3 +- Z d -3 <br />CONTACT EMAIL: o h e R nrYj�►'la,45ol?, Clipl�`t <br />BUILDING INFORMATION <br />Existing Use of Building: .M ev' C 1 C <br />Contract Price of Work: $ 70 1 000 <br />Proposed Use of Building: <br />Heat Source: ❑Gas ❑Electric El Other <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: 15kornmercial []Accessory Structure <br />Type of Project: ❑New ❑Addition ❑Remodel Repair ❑T.I. ❑Sign []Sprinkler bDernolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />�,� c 2 C1r•r ,1 k V, P uvvy `� w I �- i e Fv►i �I, e (���ta cf yril2r c <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />: <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type 11) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: Nr <br />Wedical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />Roof Drains <br />Water Heater <br />SPRINKLER [SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />No. of Heads <br />Chemical Suppression System <br />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 Only <br />PERMIT 4., o ( <br />0 (Revised 1`110012018•)1 <br />12- <br />