2930 HOYT AVE 2019-09-24 - Laserfiche WebLink

OLTPERMIT APPLICATION 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: 'Zei 30 14-d v+ Pv t 31�Q j 41 ROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision / Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Leo ts) /On c- rn 0,3 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET ki b�( 5.044- 'sT 1,3 a CITY 5rV O Lo- Ivo.- _,k STATE 04\ ZIP 11r2270 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: AS M' We T 'E S 1---- ` rij� 1/ 1L L CONTRACTOR ADDRESS: STREET '0 t L\ Ek)eP f Q2 A) W o"..y ck 2,.JS•- 6,02_ CITY V.e('.�_3 V / STATE Vjo ZIP c19ZCJL1 f ' CONTRACTOR PHONE: 92s- 3s— ---909 1 CONTRACTOR EMAIL: b€ \)\J e,I� LA, ) Up / /,c, -01 CONTRACTOR LICENSE#(REQUIRED):—j4' W W 44 q t j L j. 1Y\ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED PRIMARY CONTACT: 0 OWNERCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ; Lf 2s- 2(P ' — 1 12'1 .F A4QC V CONTACT EMAIL: In,e iss d,,,) t-s..A \,J.. Q__(S !cc,M BUILDING PERMIT APPLICATION Existing Use of Building: i Contract Price of Work:$ 2700.(!)C Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ?-eila-c &e d+ k'cc er .4- eo-�a 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 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/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water ' 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 t e State Contractors Law 18.27 RCW and 6.200A WAC. City Everett Official Use Only 7T i7 / P #w v....40� -003 Owner/Authorized Agent Signature Date (Revised 9/23/2016)