3628 WETMORE AVE 2019-11-07 - Laserfiche WebLink

PERMIT APPLICATION■ BUILDING / MECHANICAL/ PLUMBING/SIGN /SPRINKLER/DEMOLITION _. CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE • - TI• PROJECT SITE ADDRESS: 3 4 2 d jAJfhwt o-v',G 4.\\/ P-OPERTY TAX#: -- LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: GtvileSfr(AX,...5c) >? TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 0, 9 .p17-3G Cp CIN tVV€ 1! ZIP STATE ' " DD Y •e.1�f OWNER PHONE: /Z5 147p"T/ , OWNER EMAIL: ML9 y�`h CONTRACTOR NAME: LJV --- CONTRACTOR 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: ZSR 41, 1? 4 a}vie-5 Moc� ' CONTACT EMAIL: _j 4 Q 5 JI( C Tr O �� v.: Go 1 BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑AD ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑RemodelRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Ike f(ACe1 drip e "((je, av „ffAtte v (35 /) 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 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/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 03- (q ` ( y PE 03 003 4 ner/Authorized Agent:ignature Date (Revised 10/10/2018)