2528 MAPLE ST 2019-11-06 - Laserfiche WebLink

PERMIT APPLICATIO Ix BUILDIN�ECHANICAL/ PLUMBING ISIGN TSPRINKLER I DEMOLITION EVERETTCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Bluie or`Black ink Chili PleiS , PRpJECT,'SITE`INFORMATION: ., ;r, PROJECT SITE ADDRESS: 25'2 S YYl Q V L.s cS r PROPERTY TAX#: 60)5 f j 9 5 -- 4.07._90C' LEGAL for new construction: Short Plat/subdivision NVA Lot No. (attach copy of long legal description) CONTACT IMFORMIIA 1'i' OWNER NAME: M,N)1 t 6_32A, ,, TENANT BUSINESS NAME(Commercial): lJ 1 1 OWNER MAILING ADDRESS: STREET�2S 2nq —Y'v- A 91..... .., ST €� CITY Ear�``�, y y STATE W fl ZIP O Le OWNER PHONE: --ZS* 21-4 43 4 S OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: IlifOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: L—Z S Z Eke :6-- . , -DA'N G rzfA _'..s t Yz. CONTACT EMAIL: 0 CM-Lk, I _; : .... ._ :> . ..... -BUrLD,i�NG:INFORMAT. . 0... Existing Use of Building: S F g-- Contract Price of Wor :$ 2-00 (65-7-3 Proposed Use of Building: S P 2 Heat Source: ❑Ga• ❑Electric ❑Other BUILDING USE:, SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accesso tructure Type of Project: ❑New ❑Addition ❑Remodel XRepair ❑T.I. ❑Sign ❑Sprin er ❑Demolition ❑Chan• of Use DESCRIPTION OF WORK: Riepta‘IS EN.c 1 S i►,ry v` FaAyr i V ort,c:-K1 517. 4 - , c-L- AA) Wo ad vul y'flea-s4 Y irtia- TYZ f31'fi 1) 7-X Yr► ATE'tt4 P L 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 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 Ventilatior 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 ':-.,-t-ORIN-KLEit r 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 corool with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only ' I5 ) 9 F '.nos ' 0\ 0 Owner/Authorized Agent Signature , Dat (Revised 4/15/201&) a