8530 10TH AVE W 2019-09-17 - Laserfiche WebLink

II II PERMIT APPLICAT I b4#11PLBUILDING/MECHANICAL I PLUMBING/SIO)SPRINKLER/DEMOLITION „,":4:: CITY OF EVERETT PERMIT SERVICES 1 ' 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps©everettwa.gov I www.everettwa.gov/permits PROJECT SITE ADDRESS'- 5- .i & te. ipti utQ 4101PROPERTY TAX#: ()i 39 1 i dioori;0 I 1 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) OWNER NAME: - -; � :.� _� ... .. . ,,..:a;, jsIke c tq A)kilt, t)oQcJ L1 G TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET A D 1 � 14 S 1k 4 N GO y $u i t p5 W CRY S e4,441ll STATE L/)P�C ZIP / i/Xi OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: G.al,rro f 4 Q1 W,�s I,i&wq ,'p? Vh)G CONTRACTOR ADDRESS: t STREET ('/ ',�t' c _ ,� .._..- _ ...r. -.__-:. _ CIN (664 Li(111 ' STATE tun ZIP /13 a CONTRACTOR PHONE: '"'g(yt ';1'-') 1) 0 0 CONTRACTOR EMAIL:,Fjclz.t e (f�ylfJt nF/u tc16�`,v a#,e, CONTRACTOR LICENSE#(REQUIRED): rix r Po to j i�''f L CITY OF EVERETT BUSINESS UCENSEI� #(REQUIRED): am(o4 PRIMARY CONTACT: O OWNER 1a CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME:/t t iJeiZ,#o1 CONTACT PHONE: 3 4,0 $/I I X 00 CONTACT EMAIL:—M" ` ar � �41'�dl" !! AS�IrV��D� L'o�t Existing Use of Building: Contract Price of Work:ffi "" 1' , 3 L Proposed Use of BulidingL CAr po ri5 Heat Source: °Gas ©Electric ❑Other Building Type: ❑SFR-Detached ❑S(R-Attached °Duplex ❑Multi-Famiiy4of Units: ❑Commercial (Industrial Type of Project °New ©Addition ❑Remodel DRepair DT.I. OSign £)Sprinkler °Demolition ❑Change of Use DESCRIPTION OF WORK: Spec iq ity coiu p_4 A , ,, 5el f ISI i Fenth., ASSOCIATED BUILDING PERMIT#(if applicable): f 1">T 4 Ii! / 5f, ;j/ ' ECH I? • 'I +li _, :`..... BIN ,v,' .,.w �1 , s Type of Project: Now„ Addn _ Alteration Repair Type of Project: New _Addn Alteration _Repair #of List of Fixtures #of List of Fixtures #°f List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C–Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) 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: 1 - 'Chemical or Water .,. '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 taw.The granting of a permit only authorizes approved work end no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.tam the owner,or I am authorized by the owner of this property to perform the work for which appioation is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT own,z;iitx,,„ /„...... 9 rizegent Signature ate (Revised 9/23/2016) C__