3709 25TH ST 2019-09-18 - Laserfiche WebLink

PERMIT APPLICAIIOI� c.i..• BUILDING /MECHANICAL/PLUMBING /SIGN /SPRINKLER/DEMOLITION 14111WCITY OF EVERETT PERMIT SERVICES 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 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 3 -7 Qq 2...s---til Si--t 5Ye,-7-- wct PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: ch y.i-S+tGvo,/ CE9rorr&ei-o TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET/ /1 32 i r./ (_,i{.Ite S ,00e_ i a a q CITY L.IL S/'""ei✓cis-,S STATE w C4 ZIP 9'Z OWNER PHONE: 1125 -7 5-6 0 L/-7S OWNER EMAIL: (,GLGex,'ufi''A-c4-o,zS l 'Ti'''1-krf: .GpM CONTRACTOR NAME (`j W iJ eiir CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: pi OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Li2S 5''"43 0°-1 ')S— CAC A ✓`t54"t A./ (o conica-0 CONTACT EMAIL: LeG©.,i.---,e,ccc. eyty E ti-o-r ei al G. Co'vi BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ 5,5oe Proposed Use of Building: Heat Source: ❑Gas 0 Electric ❑Other BUILDING USE: , SFR @Townhouse 0 Duplex DADU ❑Multi-Family-#Units: ❑Commercial DAccessory Structure Type of Project: ❑New DAddition pRemodel ❑Repair DT.I. ❑Sign @Sprinkler @Demolition ❑Change of Use DESCRIPTION OF WORK: dye- (L ot7F r - Po'),9/ 5- ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures count List of F' ures Counf List of Fixtures Count L'= of Fixtures NC—Air Handling Units Gas P' Ing Backflow Preventer(Inside Bldg) Sho - ,Tub,or Combo Boiler G Range Clothes Washer ' -Commercial(3-comp,prep,floor) Clothes Dryer eat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type 11 Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Re ' ential) Wood Stove Interceptor-Sand/0' Water Service(behind meter) Forced Air Sy ms Other: Medical Gas Water Valves or Fixtures Gas Firepl e/lnsert/Log Roof Dra'• Water Heater SPRI LER/SUPPRESSION SYSTEM Se -ge Ejector or Sump Pump Other: hemical or Water No.of Heads ACK40WLEDGEMENT: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 t 2- 1 l 3-f/9 P T\#R.07— O‘ 4 OwnerlAut . ed gent Signature Date (Revised 10/10/2018) O