505 61ST ST SE 2019-09-10 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER I DEMOLITION CITY OF EVERETT PERMIT SERVICES 4677. 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 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION dk PROJECT SITE ADDRESS:5O n Lam\ a_ PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:�\\t\ 4, 1 v� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5)IC._ Lq\ ? _ CITY 5-S-- -:\\- STATE ZIP . OWNER PHONE ac ,•acn- (: ,r� OWNER EMAIL: ��a ti ��,�, `(\�\1( c.��- CONTRACTOR NAME: fAv1 iAi 1o,-ht� , ► `C • CONTRACTOR ADDRESS: STREET \ (v 5� --s) ,,,,,,,, ,,q . --NT:,_\01 CITY'...,,cN -,Q, STATE ZIP :C-)\-1- CONTRACTOR PHONE: - 5-\\- -.§:),T. 2CONTRACTOR EMAIL: 0 2 1-1),/-6 CONTRACTOR LICENSE#(REQUIRED): L / i I d33 pfru CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): e41444- PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ sg 6O,�� Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.1. DSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: V\SATt C kg I r�S i 1 J 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 #°{ List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal 5 Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap 1 Gas Range Ducting Dishwasher Roof Drains ' Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood i 121v b.l-)e_ Water Heater Other: Exhaust Fan 0 Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/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. City of Everett Official Use Only - PERMIT# '� ,z4VN ' Q_" -‘\ lMflbLP ~ 0O2 Owner/Author•e. •gen Sig tip Date (Revised 9/23/2016)