1602 BAKER AVE 2019-10-30 - Laserfiche WebLink

PERMIT APPLICATIO "Opp - BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION lerigie, 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�t 4 4A)6g A' ii/7 41,4 71,2h 1 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 4g 1 c E✓fi i TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET ttom�/47 D 2 , 4 Kt, ,4aAI11 S /� + f cIT1' RC1'P/c l i� �`� STATE �,(,I,Q ZIP 7�o , OWNER PHONE: `k 2s k 22- CgLACU 2j OWNER EMAIL: 14 )\ CONTRACTOR NAME: rV 7/1 CONTRACTOR ADDRESS: STREET ` i ..—• CITY r N4 ".se STATE ZIP CONTRACTOR PHONE: __ IL" CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: OCZ CONTACT EMAIL: BUILDING INFORMATION Existing Use of Building: /qCk on(, Contract Price of Work:$ Proposed Use offB ilding: f,,, Dpsi Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: OLISFR ❑Townhouse ❑Duplex OA/DU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure�� Type of Project: ❑New ❑Addition ❑Remodel tepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: / 1eb A t 1O c7 i),5 t.ILL0 -k-st1/41,,,,701.0,...‘..c.., 1TaxisNot.,Si c"- e);0,- (-n- ex_ Ace.xStle ASSOCIATED BUILDING PERMIT#(ifPP alicable): `s 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 NC-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 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. ( City offEverett Official Use Only IPA ir I lie- iej-7?- i,p PES T\�0`-'l '—o n Owner/Authorized Agent Signet e Date (Revise 10/10/2018) /Th