3006 15TH ST 2019-11-15 - Laserfiche WebLink

,1","0,,,---_,F-44PERMIT 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 I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: l" - I#1,6, cu5 3 U(06 1St k Sf MI PROPERTY TAX#: /3- i q 1 A 5 a LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) 4 CONTACT INFORMATION: OWNER NAME: ba 110 4 �vili HA 13(AN TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 1020 lit' cuie 4102 CITY Sea -f(e, STATE w'4 - ZIP eg J OWNER PHONE: lig S 53) 116 I OWNER EMAIL: sl/(^I+11 lour ..c-i tlA/ta( i, 6 6144- CONTRACTOR NAME: C, (J)(4-f CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 14 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: (� CONTACT PHONE: t4,2,`j 53 i 11 6 I I J( i 4 5 i�I TL IA IE u I/` CONTACT EMAIL: �Cj l�il I T►( fit ( �1/1�1�1 f rC (4A-.BUILDING INFORMATION n Existing Use of Building: res j ci evt f1 d\, Contract Price of Work:$ 301 O d 6 + Proposed Use of Building: fest'ate of a` Heat Source: ❑Gas KElectric ❑Other BUILDING USE: ❑SFR ❑Townhouse M suplex ❑ADU ❑Multi-Family-#Units: OCommercial ❑Accessory Structure Type of Project: ❑New ❑Addition ■Remodel ❑Repair ❑T.i. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: remade) 1 re c-j r dower -Floor df ot,(e . k, 4i-It-• Orem .q flits floor pkvt1 wave IA IltW?ce / odve la,'/et vami ilA bAr-11r0d . 6�— -' SC51 '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 NC-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo _ Boiler Gas Range olr Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless .� Dishwasher II. Sink-Residential(kitchen,bath,bar) Duct System(Remodel) if Refrigeration Drinking Fountain Sink-Utility,laundry,mop o2- 'Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet , t. 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 INo.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 ify r�i o /4 I t 7C/1 PERMIT# Qqaa —00 Owner/Authorize ent Signature Date (Revised 10/10/2018) .,-