2404 75TH ST SE 2019-09-18 - Laserfiche WebLink

PERMIT APPLICATION 011.1111P-4BI7 WING/MECHANICAL/PLUMBING I SIGN/SPRINKLER 1 DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(F)everetteps@everettwa.gov I www.everettwa.gov/permits *4.6- cr SITE 11 5 .r= .s A° PROJECT SITE ADDRESS: Z Lk)y 7 S TN 5%7- PROPERTY TAX#:Z f>Q S rQE3�O Za`['/DD LEGAL for new constriction: Short Platieubdivision Lot No. (attach copy of long legal description) OWNER NAME: J19HAJ JE IAJ/.v(v$ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTncEr /d/2/ G y/r6 Reif.. .t/ WAY'' z f- -r 9 cJ cm? .�✓0.ir 6r 7 l STATE 11/1/4? zP !B L d 3 OWNER PHONE: ao ��~ ce,l--7 is OWNER EMAiL Jot-1fJ Y..,_G"x{,....4.1 . e o ev1 CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET OTT STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED(: PRIMARY CONTACT: 1$OWNER 0 CONTRACTOR D OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Z- ' ct:t 5/- 2.7 6 Ja/a„f Jam//If/I.iQ Ej 1 CONTACT EMAIL: Jr.. ..w1 �ri.�5.4/.n t t1 Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas DElectric DOther Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: G/k G E.-.4 '-v ftTga'_ 41A! ASSOCIATED BUILDING PERMIT#(if applicable): i;....,.a .. : ...< . VAW4i Type of Project: New_ Addn _Alteration _Repair Type of Project: _New _Adds _Alteration XRepair Fixtures List of Fixtures FiMut List ofFixtures FixturesList of Fixtures Fixtures List of Fixtures NC-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/Mopfetc.) Other:f/)e' COAX fjtp din/3/A/ Chemical or Water J INo.of Heads ACKNOWLEDGEMENT.1 have reviewed this application and confirm the information contained herein is true end correct.Work done pursuant to this permit must comply with current federal,state,and local raw.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,leen the owner,art am nuthoraed 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. ity Of Everett Official Use Only f PERMIT# Dwnerf thorn. Agent 3 g nature Date (Revised 923/2016)