1450 80TH ST SW 2019-09-18 - Laserfiche WebLink

(i4ierrPERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN/SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: NO 8O1h' if Sid Eitirce PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: nigp ,.eto P(prtc d TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Saha AO Alg114 CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: JI,tP$Jj F."1re, frofe(+Io1v CONTRACTOR ADDRESS: STREET r 0 2 O III 1 p CITY arailIk Fal( STATE ( 1/i zip insa CONTRACTOR PHONE: af2r 41.3 ifs- 61143 del( CONTRACTOR EMAIL:?Wail mitt".cos' CONTRACTOR LICENSE#(REQUIRED): BHAN5Ii1 sqi pU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER yiCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: ` i4 rt* CONTACT PHONE: *5' 3w- Vi a14 CONTACT EMAIL: Dog bq,(gl/s,Pt,r, „ton, BUILDING PERMIT APPLICATION Existing Use of Building: /NthafgAiltu►r�l lidStar Contract Price of Work:$ ISM* Proposed Use of Building: $amQ_ Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: pG`ommercial ❑Industrial Type of Project: ❑New ❑Addition El Remodel ❑Repair 21`.I. ❑Sign ,prinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: r' Q44* vat Y G- tel, Qp 6.0,,, tio & MI qac. ► d� ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New_ Addn _Alteration _Repair Type of Project: New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of 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: SPRINKLER/SUPPRESSION SYSTEM 'Chemical or Water ( Gi 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 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 Q10, 117.th- Rl sit p f PERM \ Owner/Authorized Agent Signature Date (Revised 9/23/2016)