1114 59TH PL SW 2019-09-18 - Laserfiche WebLink

F5Ite'r CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 982 (P)425-257-8810 ) FAX 425-257-8857 (E)everetteps©everettwa.go�www.everettwa.gov/permits (BNuleor Blip int/Only Pisasiir) ,; 1PBDJEOT4NTE:iNiFO1itMATia1!i `< PROJECT SITE ADDRESS: y` IoC' (Nf EVOeft,N)A2 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) cgNTAcT INFORMATION` . OWNER NAME: I YUi 11)011 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDR SS: STREET '31b S 9111 ST CITY \4CUiry STATE 1\161011 ZIP 1 �- - OWNER PHONE: Zr ! z�\,—. p�: OWNER EMAIL: {nimS �_;jx3(` ) ,fir c' . (1e(- CONTRACTOR NAME: Triy,,4 V G (\&Y CONTRACTOR ADDRESS: f STREET 3 { `v r CITY "ra4 Vl+* STATE v1..!' t tt,J iilf v ZIP 401 tr-Tu.,1, CONTRACTOR PHONE: 253--2 2,1 -- i 42- CONTRACTOR EMAIL: Ot�'i?')'1ci1i: �1 t'J C(riWa4fi bet CONTRACTOR LICENSE#(REQUIRED): Af s A L ;�3 N. . CITY OF EVERETT BUSINESS UCENSE#(REQUIRED): '1(& r PRIMARY CONTACT: IS OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: t� CONTACT PHONE: 20.3 --22,1 - 1(ea 1 10 �t f&'Y CONTACT EMAIL: t,, renstyoN f (o - OUILDING`INFORMATION Existing Use of Building: s'F-g. Contract Price of Work:S Lel l 000. 00 Proposed Use of Building: 5 r . _Heat Source: OGas ❑Electric ❑Other _ BUILDING USE: $SFR OTownhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition IiiiRemodel ❑Repair DT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: e. too Sri. ASSOCIATED BUILDING PERMIT#(if applicable): 4 a. 1cAkP .. . . , , . LIO looN ' '* , .tP'ERMM1T A PI IOATION Fixture Ftxmre Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat 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 II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oif Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER-I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 'No.of Heads ACKNOWLEDGEMENT:t have reviewed this application end 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,ort 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 r :;''. pr�i eS1 )--) i uppres PER T#ettd.„ t _ w .,,,4 Owner/Authorized Agent Signature Date (Revise 10/10/2018)