6627 HIGHLAND DR 2019-11-14 - Laserfiche WebLink

miii PERMIT APPLICATIC BE BUILDING I MECHANICAL / PLUMBING / SIGN I SPRINKLER/ DEMOLITION EVERETTCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PRO_. 7 �T SITE INF RM ION PROJECT SITE ADDRESS: 6 lA-rLiaPROPERTY TAX#:6653 I7 O j-C fSOO (77 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: '/ 7.X1 7? /) 6- TENANT BUST NAME(Commercial): OWNER MAILING ADDRESS: STREET th.. _a 7 # o'"" L.c cze CITY �� STATE4,19, ZIP g��/�y/�� c (c..1% t .0 _t/•�a � � OWNER EMAIL: V h Yr(�A� OWNER PHONE:J11 i�; .�� lJ� �: -C..� I CONTRACTOR NAME: ""!rl t�1f Ftb 0 1- CONTRACTOR ADDRESS: STREET '4 7/Y CITY �l% r/1 STATE (j Y ZIP gCy�zC7� CONTRACTOR PHONE:, lat'" k._ 046.4-1. 1,g J CONTRACTOR EMAIL: (, \a kr, [�("fl� -`ct CONTRACTOR LICENSE#(REQUIRED)E1rA7gp$ Ic 3 ( CITY OF EVERETT BUSINESS LICENSE#(REQUIRE Fi \AA T PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (1 �I G+� <�J1t \ CONTACT EMAIL: c � .� iM l l; C c4 BUILDING INFORMATION /9%//� Existing Use of Building: Contract Price of Work:$ e�� ,t'` Li/ .' Proposed Use of Building: Heat Source: ‘,...atlas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse Duplex DADU 0 Multi-Family-#Units: ❑Commercial DAccessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑De olition Change of Use DESCRIPTION OF WORK: L, t. 6-14:—.6 i' ', Pt- L c z —A'\ � e, w c -- bt �+��i6 '-4 d 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 #a 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 i SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System! No.of Heads. ACKNOWLEDGEMENT:I have reviewed thi•application a . • firm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal,.state,and local law. The gra ing of- •-rmit onl authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Oficial before being authorized un.-r a•,circumstan%e.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, andIofi ply with the State Contractors -w :.27 RCW an. 296.200A WAC. City of Everett Official Use Only --//• _ PERI\4 Owner!, •.rized Agent Signature Dat- (Revised 4/15/2019)