4713 HARBOR LN 2016-05-23 - Laserfiche WebLink

425-252-1666 c.m.heating 12:38:02 01-15-2016 1 1 4ZETT • PERMIT APPLICATION • BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 90201 (P)425-257-8810 I FAX 425-257-0057 I(E)evereltops@everettwa,gov I www.everettwa.gev/permIts PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 41113 t t \ } 0 n LA w 17 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision f i'1 C Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 1p oxy\e (tt ;'-')il I NZ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET LI— \3 )--1 of-j30h L4A j\-) . / 7 CITY eL� � � l� . � STATE �'1/ ZAP �(� OWNER PHONE: `\.Z`7 LI ( 1-7� OWNER EMAIL: CONTRACTOR NAME: ii ' 1, a a / CONTRACTOR ADDRESS: STREET il-i15' 13rOAcitioa CITY EVe,r e STATE WA 1,, ZIP qg 2 CONTRACTOR PHONE: 9 Z5 2.5q (vro (pC7 'CONTRACTOR EMAIL: debbie �Crnti€ -ivi • ( ,yy CONTRACTOR LICENSE#(REQUIRED): Cm N E A I*Oct R LI CITY OF EVERE t I BUSINESS LICENSE#(REQUIRED); 0 1 CI bQg PRIMARY CONTACT: ❑ OWNER cifCONTRACTOR ❑OTHER(Please Specify) CONTACTjNAME: CONTACT PHONE: 9Z5 25' 6669Co Debbie T3 Q ue rS CONTACT EMAIL: dee o cnrc kI e or-hyi , ca ryn { BUILDING'?PERMITAPPLICATION Existing Use of Building: Contract Price of Work: $ .('7 co Proposed Use of Building: Heat Source: \CjGas DElectric ❑Other Building Type: ❑SFR-Detached ,SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New DAddition ❑Remodel ti.Repair ❑T.i. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ASSOCIATED BUILDING PERMIT#(if applicable): 'MECHANICAL PERMIT:APPLICATION PLUMBING PERMIT APPLICATION Typo of Project: Now _ Addn __Alteration )I Ropalr Type of Project: Now _Addn _Alteration .Repair Fixtures list of Fixtures Fixtures List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures AIC-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boller 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`SYSTEWr.'I;.. Number of Heads ACKNOWi FOGEMENT: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 Oficial before being authorized under any circumstance.I em the owner, or I am authorized by the owner of this property to perform Me work for which application Is made, and I comply with The Slate Contractors Law 11).27 RCW and 295.2004 WAC. City of Everett Official Use Only PERMIT# wQ-b'1Ac5 111CLIle ry heal -Cx13 nor/Authorized A t Signature Ca (Revised 10/12/2015)