8910 4TH PL SE 2019-11-14 - Laserfiche WebLink

mII II PERMIT APPLICATI icy BUILDING TMECHANICAL I PLUMBING I SIGAoRINKLER I DEMOLITION EVERETTCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black,Ink Only�°Pl eased PROJECT:SITE INFORMATION`,.. .:..,s. ... `,,.•, PROJECT SITE ADDRESS: c,)}O 4"I^ P L SE' Fvtreff WI'T- PROPERTY TAX#: 0 cit 01600 00600 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) . . CONTACT INFORMA 'IONF . . OWNER NAME: TRP4-1\,) (X.T at 140 TI U) TRAN6NANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 190 7 97 hof 1-`.,$PS CITY V e-RE ft t STATE V`' ZIP 9v 2-0 Ci OWNER PHONE: 1 �GI _ 441t(. OWNER EMAIL: I r}V� V ,14( 0.ytv( U C ,, CONTRACTOR NAME: ,1w CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 217 s —1)11- -44-1.11 11R Q/i H ) CONTACT EMAIL: T THAI,/T R. toot g C a Yk`li-O'(?. LifD'\' itObRRM. old .,. . ' .Bt��LDING.X "ATI . . : Existing Use of Building: Contract Price of Work:$ 11.70-()____. Proposed Use of Building: De_c4-- k¢.}j�i,tot, Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: $]SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: • ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL;P ERMI( .., PLUMBlING PERMIT APPLIcAT�ON.:.. . �, T APPLICATIE'SN, ..... .... .,. 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 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 Official before being authorized under any circumstance.I am the owner,or lam 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. r ip( 1City of Everett OfficialUs aUse Only c .,__d 0510 I / ,J PERM tl D9-- V V I Owner/Authorized A nt S ature Date (Revised 4/15/2019) 11