214 77TH PL SW 2019-09-18 - Laserfiche WebLink

PERMIT APPLICATION OLTBUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everelleps@evereftwa.gov I www.everetttitia.gov/permlis (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS; ) („ , -77'hl P� t [PROPERTY TAX#: LEGAL for new construction: Short Piatisubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: ' i „ --Hrt , ? TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Olt L.-.. I Tr'''. P L. SU...) cr,, ; K. t4d STATE + m.. ZIP V> 0./OWNER PHONE: 2 ,T..ys ^y.^..�,✓ 'OWNER EMAIL: CONTRACTOR NAME: CA “eaktritl C. CONTRACTOR ADDRESS: STREET 14 broactwa-m cnY t. T,^�I✓ L.+ . , ZIP * � a2,. 1 STATE CONTRACTOR PHONE: q, 0 0 CONTRACTOR EMAIL' r °r �. .�I � _,,,j4 .'s i no .Co CONTRACTOR LICENSE#(REQUIRED}•exeit - t ci R_ti- CITY or EVERETT BUSINESS LICENSE#(REQUIRED): 0,679 PRIMARY CONTACT: 0 OWNER ' CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME; CONTACT PHONE: CONTACT EMAIL:acialo a e c ,... Com — BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ )2 IS 5 Proposed Use of Building: Heat Source: ❑Gas .+ iectric ❑Other Building Type: SFR-Detached ❑SFR-Attached ❑Duplex EMulti-Family4 of Units, ❑Commercial ❑Industrial Type of Project: El New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Cheng#of Use DESCRIPTION OF WORK: l vis f_ - olt..,c*t KQ+ p ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Profect: ,New Addn Alteration —Repair Type of Project: _New Addn Alteration —Repair #of — -._. I.1st_of Fixtures_. #of #of Fixtures' Fixtures est of Fixtures List-of Fixtures #of Fixtures -- —List of Fixtures A/C—Air Handling Units ( Heat Pump _Fixtures Toilet Backflow Prevenfer(Inside Bldg) ✓orr.ed Air Systems Unit Heater Bathtub Gas Piping Urinal Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Gas Fireplace WFloor Drain Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Clothes Dryer Hookups Other; Roof Drains Range Hood Clothes Washer Medical Gas Exhaust Fan Water HeaterOther: Sink Service/Bar/Mo /etc.) Other: SPRINKLER/SUPPRESSION SYSTEM (Chemical or Water I JNo.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 Oficial before being authorized under any circumstance.t am the owner,art am authorized by the owner of this property to perform the work for which application is made, and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC, City of Everett Official Use Only �� j / -�r 7 PERMIT/#� �� 1 Ow ariAuthorixed lags Signature t - �� C ' cDate (Revised 9f23/2076)