3123 NORTON AVE A 2019-11-06 - Laserfiche WebLink

® PERMIT APPLICATIO mi BUILDINC1CHANICAL/ PLUMBING /SIGN ' INKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVIC 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 (Blue or Black Ink Only Please) +� PROJECT SITE INFORMATION PROJECT SITE ADDRESS: ,3 )p�. `�A/�v .4-n vl / _ PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: / 1 e j �--_____•)£ vet -I y" TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET i2 36.-.) /V 5-‘ s -1--- S4,6 /i CITY STATE 'J,(J j4 ZIP 9p1e:5. 3 OWNER PHONE: g 0 (� ' 7 )-7- .�- 10 OWNER EMAIL: e ], L.1 , -21,,A-: -- 42- 1 Cai"- _ � „syr 4CONTCONTRACTOR NAME: .� I CO --c- CONTRACTOR RACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 'OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (1.). a 4, 6 j 7 - 5—c-0 61 Li_q S tel. t ..S, CONTACT EMAIL: ! Levi ' -S„s t i-1-14 3 ..2-0.. •yt4c1L> 1 , uc,..--- BUILDING INFORMATION C Existing Use of Building: P v\_14 , Contract Price of Work:$ t , )C)O . _.- Proposed .Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ZIDuplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 1 ‘----7604-- ASSOCIATED 604— 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 A/C—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/InserULog 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 of Everett Official Use Only '1 ,,,,4_,_ PERMIT#6` 0 D j 6 / 7//, Owner/Authorized Agent Signature Date (Revised 4/15/2019)