5108 ALTA DR 2019-09-04 - Laserfiche WebLink

® PER,,,IT APPLICATIC BUILDING I MECHANICAL I PL UI BIL'v'G I SIGN i SPRINKLER l DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: ,, i a ;r\ i i t,-+,r- -i ; ((;G Lt:'' PROPERTY TAX#: _:,)37756000 22-02-- LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: -1-3-70/J ?'?Ni iz 7 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 5( 6 /-1 fr-,- Lir 7%""0--- CITY '--CITY -e,,.„...,,y-- STATE 1.1-46-- ZIP r-::(J JU OWNER PHONE: q:i(31 ?Qi 1 /b OWNER EMAIL: ..... ,... ,_y,., CONTRACTOR NAME: ITt? ~^--e- (D `-- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): !CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR in OTHER(Please Specify) a ' CONTACT NAME: CONTACT PHONE: 1-2,60 D f S — 2-9`i . C4 r24c tirlSlt CONTACT EMAIL: C a�'"4 l 6i,vys- 1. 7 k+--�i r i rid --- BUILDING INFORMATION Existing Use of Building: (j i,--t5L"' tin,Ii. / Contract Price of Work:$ 4. 2--S e• (,—c,-, Proposed Use of Building: 1-r_-,t_ u. {1'' -'t .�,..() 14-i 6^-, Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New DAddition E7 Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: /Ah--i o A—u7 d 2 U /Q-a a S /1--A-r,--1406,4-7-11/ 11-6 e ^~1 RL 0-14-va_ - 6' 6 6 it ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) / Shower,Tub,or Combo Boiler Gas Range ( Clothes Washer 7 Sink-Commercial(3-comp,prep,floor) ( Clothes Dryer Heat Pump&Ductless Dishwasher ( Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain f Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT* • . -- ...Sr- ( 11 ( lq Owner/Authorized Agent Signature Date (Revised 4/15/2019) 1,/--,