710 84TH ST SE 2019-09-18 - Laserfiche WebLink

PERMIT APPLICATION . ../477 BUILDING / 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)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please)) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 71 U '31-144-1 +" St_ PROPERTY TAX#: 5i � j e LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: )6 f---0. 1 \.) ,e TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET c7�^ )D -41 `3 5t, CITY LA),-U"l "-f" r[' STATE V J/ - ZIP 98�� OWNER PHONE: Olin) ' j0/- �f/1 OWNER EMAIL: {01 1 l,(—�u e C� o...,v,,z5�',1/�-- CONTRACTOR NAME: NI yl er r' \ ect- (p) \RC CONTRACTOR ADDRESS: J STREET I "� 'i 3j 3 Hi Jy 1....44.1111 r ,\' ^J1 ? CITY I1 l �C , STATE ,/l, ZIP 5 J62 CONTRACTOR PHONE: 0 ) I- 153 CONTRACTOR EMAIL: Ali L1,- }i4 Q U,ty,s ,ti ..(:_try‘ CONTRACTOR LICENSE#(REQUIRED): K/ j ) -1 U`Ij 4 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) (J 7) PRIMARY CONTACT: OWNER ❑ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: �� + CONTACT PHONE: (�,I-0 ) /�Qnj? - ?/, 4 L1' ` yof I CONTACT EMAIL: V r I i L� '(�/a#/� �t/ �kiA.rl�ls� �,Y\ �� 1 BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ iCil G(:'`% Proposed Use of Building: Heat Source: -Gas El Electric ❑Other Building Type: ❑SFR-Detached I SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition DRemodel ,Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: PLe,p i&C t8c-\JRlC 04'18 C ts. f Ceyn,c)Vl i o t - Li 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 I 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 1 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 locpl law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Buil.ing Official.I6re b g authori unde'any circu ance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, a .I comply lithe ate Contr .rs L: ' 18,/ RC and 296.200A WAC. / City of Everett Official Use Only / lJ PERMIT# 2' ID/g60 /18 Owner/Authorized Ag•nt Si. ature Date (Revised 9/23/2016)