1802 VIRGINIA AVE 2019-11-07 - Laserfiche WebLink

PERMIT APPLICATION 112 BUILDIN INECHANICAL / PLUMBING / SIGN ) J RINKLER/ DEMOLITION E V E R E T TCITY 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 1 www.everettwa.gov/permits (Blue or Black Ink Only Please)/ PROJECT SITE INFORMATION PROJECT SITE ADDRESS: /5Z)_2_ 01( ,,H 10 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) l CONTACT INFORMATION OWNER NAME:]ll�p a\Q, 5 -. Rv i c1c __c4I p2c 1L TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET /f Oa (/I t(' /7 lc( cm, L'f'ft eR./ STATE L7IIIy""" ZIP Cr-�C7i 4a5----OWNER PHONE: 4a5---- � -f gi I 0 ,z CI OWNER EMAIL: _co Lk 1 ik orf—i/kc-ti' C''.a.VIA CONTRACTOR NAME: O 423 OP K CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: IKI OWNER ❑CONTRACTOR 0 OTHER(Please Specify) , CONTACT NAME'" CONTACT PHONE: 9,3 .1--- — a yp ---t' (P 0 �V C1 PoGk CONTACT EMAIL: - y S4-7 pRcQ kzi_I11a1/•Co✓t BUILDING INFORMATION Existing Use of Building:' F MfL_ /.,a W Contract Price of Work:$ `'L. .S7c, Proposed Use of Building: r rLt r J ,. A 7W2 Heat Source: Gas ❑Electric ❑Other BUILDING USE:°1SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project:tt ❑New DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: (-P r 07, S' -- —(--4"6 V. DO V e r 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,tt or) 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 1 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 OM.-- .efore being authorized under any circumstance.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I corn.y wit the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only / 't PERMIT# 1 Cr — lam ri - t '-C Owner Authorized Agent Sign. re Date (Revised 4/15/2019)