319 PARK PL 2019-09-24 - Laserfiche WebLink

I grr PERMIT APPLICATIql BUILDINA / MECHANICAL / PLUMBING / SIG SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 /" (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 ,'.evera. erm s (Blue or Black Ink Only Please) PROJECT SITE INFORMATION F � PROJECT SITE ADDRESS: b 1l 11 r - R, i 'Ci vey �1 w A 43ROPERTY TAX#: 001/'0 U 0 0001400 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy 6,.ng legal descri. '. CONTACT INFORMATION OWNER NAME: (Ly / AJ 7t TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET)'WI pay. Pi, cm( ,-NleyeA STATE w rk ZIP 1n(-O OWNER PHONE: 42 - `J�, q5 ie� OWNER EMAIL: Cat t h om-v I cpo ACJ, am uI -. ield- CONTRACTOR NAME: MQ . kgdr. dh RI( CONTRACTOR ADDRESS: STREET iq 11. G. t Ik j pt . crrY c,Callef STATE Y Y R ZIP 61%g CONTRACTOR PHONE: 7..-5 1) t.09 V)- iCISID CONTRACTOR EMAIL: p' (Vn h Q Tiormo;i „ (Dr CONTRACTOR LICENSE#(REQUIRED): wive '5s 3i- v.9CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): t 2ln 4_\I PRIMARY CONTACT: ❑OWNER 1CONTRACTOR- 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 7. f , [(9 (,, i gg 3 Alt\1 WI etaril CONTACT EMAIL: OT)i 1 /, a ,p 16 BUILDING INFORMATION `'"� Existing Use of Building: p-P6 dal+,a Contract Price of Wor : $ I0 t (g60 Proposed Use of Building: h iq Heat Source: ❑Ga. DElectric DOt =' BUILDING USE: INSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commerci. ■Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel Kl-epair ❑T.I. ❑Sign ❑Sprink 2 Elbe .s ion ❑Change of Use DESCRIPTION OF WORK: I1riaerr Innlrtq -f t is\iinSin Ivfa,tyLkc-td-U1 co S 2I 1Zv J un " u a ASSOCIATED BUILDING PERMIT#(if applicable): • MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 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 Contractors Law 18.27 RCW and 296.200A WAC. 1 City of Everett Official Use Only \ ..._ 6 hid M P Zgeic t 0 .......acz O ner/• thorized A.-nt Signatur= Date (Revised 10/10/2018) ' L I I