6630 OLYMPIC DR 2019-09-24 - Laserfiche WebLink

477- PERMIT 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 I(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) f PROJECT SITEITINFORMATION PROJECT SITE ADDRESS: (v((! (� ,,,,,y,„...0,...„ 1,(t,� PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: L\ �CL-k, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET a( V?"- '� Dyj!, vt1 < Ni L. CITY �'i�l..h •J STATE N Nk ZIP IfS1 OWNER PHONE: 2�• 27>1 . 41`-(`1 OWNER EMAIL: ,, CONTRACTOR NAME: r c� {�w; � ' �t i4 L`v _ Lv ' li�(�(1'b & �1:�,' Cw CONTRACTOR ADDRESS: STREET 1 ` 1‘Vg CITY t.-4D V-A./VAI L`U STATE k\CA._ ZIP 1 2, CONTRACTOR PHONE: ?Q 0 ' lt^1 C �C, . CONTRACTOR EMAIL: j n6) ,U i' k2-40.)1. f(.-i.All CONTRACTOR LICENSE#(REQUIRED): r '> \ —1'\(:.. L,a ��3`� CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): b 5& PRIMARY CONTACT: 0 OWNER (.,CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Q . `ce) ' 'S( C _� ,n, 3.eve�,)1,(�l 6a.61(\GAI\ CONTACT EMAIL: 1 in 6 CL) f Gt,.-� LY1 y�X.tt� •C°0(1 C' S BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ (COO Proposed Use of Building: Heat Source: cilGas ❑Electric ❑Other Building Type: C SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel [Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: fr� i)r-f\_,6ue.J2, (,ti moi evd 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) I 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 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, an. .mply with the State Contractors Law 18.27 RCW and 296.200A WAC. i City of Everett Official Use Only f P T# Ac,..)��fi"I �� ` 014 . Owner/Atit • :d ' •ent Signature Date (Revised 9/23/2016)