915 N BROADWAY WSU 2019-09-04 - Laserfiche WebLink

INNS PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION EVERETT ECITY OF EVERETT PERMIT SERVICES y C 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 orBleckInk Only Please); , . PROJECT;SITE INFORMATION PROJECT SITE ADDRESS: Qi5 14• 15Pci p.PtA.IH PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: OS141b 011 SI"l1(E V5RSI'I') TENANT BUSINESS NAME(Commercial): t )5t) OWNER MAILING ADDRESS: STREET 2425 E. evA•1Ms5 W CITY ,'V toLP.4 J STATE it)A. ZIP iIoll - OWNER PHONE: 5-09. $35— 41437 OWNER EMAIL: L4514e.c✓1e.4 I€ Way• eC)1� CONTRACTOR NAME: NATIYS' AMEi2.44}1.0 5.00.4 e,, s CbweP• Cgottsc, CONTRACTOR ADDRESS: STREET c)3Z$5 S 1 LV me. V i L.L.,IG� Po AD 1'333/ CITY KEG LO( STATES 'X1�i4 t4 ZIP CONTRACTOR PHONE: 50 1"y32,1" 0432. g 13 1Q° ( 4CONTRACTOREMAIL: Net • 34r+G Q'5COVSa• COM CONTRACTOR LICENSE#(REQUIRED): N�4TIV,S$52 frCITY OF EVERETT BUSINESS LICENSE#(REQUIRED) '/i� l PRIMARY CONTACT: $.OWNER 0 CONTRACTOR 0 OTHER(Please Specify) ?((t62. I-11A ?! CONTACT NAME: CONTACT PHONE: 50q 326 go 31 t L.DV1sE S u yr i1" t Ni CONTACT EMAIL: I,.QtIr 61.91Qarst 4. • �I l) BUILDING'I N FORMATI ON Existing Use of Building: EDU CAT)ONft_. Contract Price of Work:$ 32.15P0 t 5T• Proposed Use of Building: VPUCATIO)0SAt. Heat Source: OGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Ncommercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel El Repair 'T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ao1Js tzocr a t14MA *ysT' M O I Rcof ?Rov a DE S krE TO EXISTI . AIR HAar►UUeRS. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION FixtureFixtura 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 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 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 PER MI # /2G i9' � �q®� - ® 3 er/Authorized Age ignature Dat (Revised 10/10/2018) C/—D