4613 BAKER DR 2019-10-30 - Laserfiche WebLink

-'' II IIIIIIII 1:11.1PERMIT APPLICATION— BUILDINCIECHANICAL 1 PLUMBING I SIGN 1 SPRINKLER 1 DEMOLITION E�/E R E TCITY OF EVERETT PERMIT SERVICES C Y G�[G J 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 j FAX 425-257-8857 j(E)everetteps@everettwa.gov i www.everettwa.gov/permits (Blue orAia4k Iink.Only Please) : PROJECT;SrTE; NFORi AT1ON ;:,:i . PROJECT SITE ADDRESS: 1+6) t 2 B ERI ("}ki\iJ PROPERTY TAX#: OD 1 7 L/000012_00 LEGAL for new construction: Short Plat/subdivision } Lot No. (attach copy of long legal description) .. ......... OWNER NAME: 0-Er-r- G R,Ceki.0 �@ R TENANTnBUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET ij L� /�(3 M `SRA"+C. IC-y L CITY/ STATE P v ZIP Q1320 3 OWNER PHONE: 2-C.JG3- COO t-- 76350 OWNER EMAIL: ..... ..... . CONTRACTOR NAME: R ea, \&)RiG 4'Y 14-0\71�� J- �J1 ,�tt j�-� CONTRACTOR ADDRESS: STREET `2„ Be #tf 0/ . >r � ..(S(� L)2 r© CITY �, STATE, (� (ZJ�P,,�,j,,' 6 CONTRACTOR PHONE:Z 0G— p.8 3- 1234 CONTRACTOR EMAIL: l aAree \AY(_k+YiGtri`(,0. e C;fi►l CONTRACTOR LICENSE#(REQUIRED): R i 1 &1[-t k 16 1 )2 1-1' CITY OF EVERETT_' JjBUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: i ^ CONTACT PHONE: 20a 63--123 if i S ; L L.Q�►- J kl CONTACT EMAIL:b L/ ve whi 44. 1R r Cow .: l ,:.. :::: :...... :_:....: .._...:.:._B.UILDN�,� _:;INIFOitll)lATO.N I : : -::. :., -.._ . .::.;: �..:::. ,:_ :: :.. :. ... :.:.-:-: .: ,... ,. .,:...: :.::. ., ,:.. .:..: Existing Use of Building: Contract Price of Work:$ � -00. QC) Proposed Use of Building: Heat Source: pg Gas ©Electric CDOther BUILDING USE: NSFR ❑Townhouse ❑Duplex DADU ❑Multi-Family:-#Units: ❑Commercial ❑Accessary Structure Type of Project: NNew ❑Addition DRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 14 E`,) GA" P rtf t ( -Co B t? 74- f-t Re? yr ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT:;APP.LICATION N:;: ). .-,;`,:.-°.: , PLUMNiNG_PERMIrAPPLi,CATION ;; . FixtureFixture 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 9_, Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump8,Ductiess Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease WasteNVater Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: .13E5 0, I Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log A Re pr? t Roof Drains Water Heater SPRINKLER1I SUPPRESSIO_N'OSTEM:=;. ;. 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 authorrized under any circumstance.lam the owner,or lam 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 of Everett Official Use Only PERMIT# 5 - o2q- 561At4g5-sPo Owner/A orized Agent Signature Date (Revised 10/10/2018)