4425 S 3RD AVE ACROWOOD CORP 2019-11-14

PERMIT APPLICATION - LI BUILDING I MECHANICAL I PLUMBING /SIGN 1 3i RINKLER I 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 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: I-1 y 2s s 2 ''d4 /q lre_.- PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 4C I'D W Doet_ c..0 r p , TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET IA t'I ?-s S 3 rA � '^/ CITY C I' - STATE V ' /4 ZIP 7F 2.6 2 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: °' km./s%A) p(vosh;j L G CONTRACTOR ADDRESS: STREET JO_ci .� I/ D x 61 /3 1 N p CITY S T// Jv. kae STATE V / ZIP/. 9 O Z9 Z CONTRACTOR PHONE: (Atr- , 17- 2ayI( CONTRACTOR EMAIL: NU =17l#4v 6A))/i,6, 1-4e es"- CONTRACTOR swCONTRACTOR LICENSE#(REQUIRED): 6H pL U et.g( G(0-- d CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)#' S. 07/ PRIMARY CONTACT: ❑ OWNER OCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: LI 2-S- 2 2. ? -2-d N L/ /U \ + e 0tAh-S6in CONTACT EMAIL: SA-M-e_.-- BUILDING INFORMATION M n �e�2,/-/ / o f ,?� Contract Price of Work:$_� 0U, oa Existing Use of Building: os Proposed Use of Building: t / Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: 0Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition .Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 12_ e ' r 13,7 4,r0 ons vnrt,� 6fe24 6-f'og. -) ASSOCIATED BUILDING PERMIT#(if applicable): `95O((>'0)7 27 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 NC—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 l Dishwasher aSink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain 3 Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) -.X e 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 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 Offi '-'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 com• ith the •ate Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only // / PERMIT I g V 6 �o� Owner/Authorized Agent Signature CJ( ( Date (Revised 4/15/2019)