720 58TH PL SW 2019-09-10 - Laserfiche WebLink

4577- PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink.Only Please} ': :PROJECT SITE INFORMATION „ PROJECT SITE ADDRESS: 7.20 se- p 2, PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) f p.„j 'p,A tz >>^S( Ji CONTACT-INFORMATION OWNER NAME: ESte,ttqDER. Ae,AsSERA NI TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET .72x f S" raL E V ex p, CITY Y STATE \V1 A ZIP 98 20 3 OWNER PHONE:(2,06) 4./8 K21 95- OWNER EMAIL: R0tzu.0 2.002, a CONTRACTOR NAME: OC CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: (CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 131.OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT 1L t�lfl�:lZ /� ��SSt>�A'►� CONTACT PHONE: 2.6 6 g/i 9� Ak s E e.A. G.a E3IR_U CONTACT EMAIL: R tew.) 2„mb2 @ y&L b rim 14A BUILDING„PERMITAPPLICATION ,, „ �< Existing Use of Building: i Contract Price of Work:$ c --) Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other Building Type: NisFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ONew ®Addition ❑Remodel ❑Repair CIT.!. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: r-- 4—u—Ci COAS ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New — Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) 4 Forced Air Systems Unit Heater Bathtub Urinal Gas Piping V Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer _Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER I SUPPRESSION SYSTEM Chemical or Water I 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. 1F � �f City of Everett OfficialUsUse tOnly F Iia, ?2 I? / / P EM#U—K2 2 0V lQ Owner/Authorized Agent Signature Date (Revised 9/23/2016)