1207 58TH ST SW 2019-09-10 - Laserfiche WebLink

PERMIT APPLICATION-. #1111 --A BUILDING•IECHANICAL/ PLUMBING /SIGN . INKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES ��M 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits ��. ;., o ii ti� ltd 4 I: iiiMi 4 ''.:'1,':1;'''. 7t. 1, C'""?':"'"'%1 �I�l 'r d l�91 y3F ISI _(l : : i : �.� j 1 _ $�y fw�_ ...z ew_.., .,.lz. "f;. _ � u,J'�� r 1 .� �tr _--,a t! r� ,nno,Y�t , + '��i � � +.4?--�aba� 1 ;" .n ��''�u16i�'�r�„ �rU i�: PROJECT SITE ADDRESS: 12 5: Si- ,. 2 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) i I,'„)i,, l o l a u -a ?II F' szoN A ItN ORMAIIO ` jj a �' ��„ �'a ah� Irl"' ��' OWNER NAME: 0) .94 1 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET .51 1 `(.t.bQ `> Zit} CITY 4 STATE 1,A.\ek. ZIP 4:7k2'0� OWNER PHONE: t `C • � -g CO() OWNER EMAIL: uv •iT k4u, \t e.fi.NV i & ' , � CONTRACTOR NAME: � `-c k . £ 0Y-)SCONTRACTOR ADDRESS: STREET Po PZ51) —1 q g CITY V STATE A— ZIP _� cu L: 1 V CONTRACTOR PHONE: 3 d • g�� C7 CONTRACTOR EMAIL: irl v z,Y,F -��-tel . 0-e111k....) CONTRACTOR LICENSE#(REQUIRED): Pi - 6' gLO Z ` CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): b6S062 PRIMARY CONTACT: 0 OWNER (,CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Slab . (.0%;& • 9''600 V .kAAc)c( AAAIN CONTACT EMAIL: 'l r-v6.7 DeLeL_SsOy") kg-ki .t xV ` P,C ( vxI lIrmncN:IG: t nl oti e , 7 r is s nio F Existing Use of Building: Contract Price of Work:$ 10 Proposed Use of Building: Heat Source: IG Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ®SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel giRepair ❑T.I. ❑Sign ❑Sprinkller ❑Demolition ❑Change of Use DESCRIPTION OF WORK: h GL l.& kc-1L-4 f4/12-ka_el ASSOCIATED BUILDING PERMIT#(if applicable): 7 I 4 ��ry" ? :I) :li s� n:: t :r"P" n a- n. : : , s 7 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 NC-Air Handling.Units Heat Pump Toilet Backflow Preventer(Inside Bldg) I Forced Air Systems Unit Heater Bathtub Urinal Gas Piping 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: 2II iil .G :* $ n Ri P E y NI YS-64:1 (III 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. City of Everett Official Use Only ', PERMIT# 3i 141 g WI l g)133 1) 2 Owner/A thorized Agent Signature Date (Revised 9/23/2016)