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2101 MCDOUGALL AVE 2019-11-06
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2101 MCDOUGALL AVE 2019-11-06
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11/6/2019 1:59:00 PM
Creation date
11/6/2019 1:58:12 PM
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Address Document
Street Name
MCDOUGALL AVE
Street Number
2101
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• I' I II PERMIT APPLICATIO <br /> iliS <br /> BUILDINU-ftIECHANICAL/PLUMBING/SIGN INKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2AO 1 1M e O6 /d l PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: S is Ce4) Wal/ TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 2401 Mc Dot,3 ithi.3 hie WA Q n <br /> Z14 CITY Evvif•vf'P- STATE ZIP 5320/ <br /> OWNER PHONE: �IZS Z 14' 2,5-09 OWNER EMAIL: <br /> CONTRACTOR NAME: Vint 4-201 Sea 4-4-fr LLC /^ <br /> CONTRACTOR ADDRESS: STREET '&.''1./e, <br /> sr C�0� AlLt`/ ( Gy <br /> jet C 4-a CITY lS� r`e,e- STATE VA p /ZIP /8 2.-0 3 <br /> CONTRACTOR PHONE: 206- 96© - 3 3 0 CONTRACTOR EMAIL: art 2 cfns-f edse911/e/Ic • co 01 <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER ('CONTRACTOR 0 OTHER(Please Specify) 7 <br /> CONTACT NAME: i CONTACT PHONE: 20& - V60- 7 33 <br /> Act M l 't 5 -Vjj CONTACT EMAIL: art @ unt-f-ed seg-F.4-Ie/1c .cove <br /> BUILDING INFORMATION ft <br /> Existing Use of Building: Contract Price of Work:$ 6, 3 3 i <br /> Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair 01-.1. ❑Sign ❑,/Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: re_imye %l Sm0/9 eta* a , bii// q 1'/ ' k2e"P" c/ ej <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/,SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System No.of Heads <br /> 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 <br /> 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 <br /> Building Official before being authorized under any circumstance.I am the owner,or!am authorized by the owner of this property to perform the work for which application is made, <br /> and!comply with e tate Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> ill_im,' PER <br /> gairdir,...oil <br /> Owner/,'thorized Agent Signature Date (Revised 1 /10/2018) <br />
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