9700 HOLLY DR 2019-09-23 - Laserfiche WebLink

PERMIT APPLICATIOli BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION /11/4±11114./ 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: `l'O 444 t,\ D VZ PROPERTY TAX#:)201-) 130050.02,0 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: \AV k..A--to -IG t 0 74, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 9 L{O i Styx,-o vi D tt CITY.61t .Tf' STATE W L • ZIP 47 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 36.T ?L J.ut;o U..,. \.C. CONTRACTOR ADDRESS: STREET Q 13 0 O 0 l ,-.�,^�., CITY 4� .S tin I• lS i/--1'Y'�°Waii. STATE (Are" ZIP 9€90171 0 CONTRACTOR PHONE: CONTRACTOR EMAIL: 1 3�0 (o�� int, SL$�� , tC3� 9� Ceb...- CONTRACTOR LICENSE#(REQUIRED): 3 Q eL.Pi.2150 00 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):Sq + q 2- PRIMARY CONTACT:\ I►^4,}WNER XCONTRACTOR XTHER(Please Speci -----,� >..i; CONTACT/ NAME:rCONTACT PHONE(LL(IS 3 L --I "3'16 Lo, i u V .0A,(Lr1 -`g odL CONTACT EMAIL: —1 ( LQ J‘s 3 e ph„, . c,„), BUILDING PERMIT APPLICATION 46t Existing Use of Building: _ f Contract Price of Wort. I5 41 Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: ❑New ❑Addition ❑Remodel El Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 0231 s Ph ►Al 1- s}Ih.k 5 2, d.J 3 �ft4rl‘, CAA. . ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New_ Addn _Alteration Repair Type of Project: New XAddn $Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f 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 3 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 I 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 Co •rs Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# v \,€ (..)--1.....lix),Lek thorized A9•. =9 nature D e (Revised 9/23/2016)