2413 56TH ST SW 2019-11-15 - Laserfiche WebLink

4:77- PERMIT APPLICAIION BUILD / MECHANICAL / PLUMBING / S ISPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please))-7 -91‘ PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2-t1 ale T �� S1/4t\f PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: P�tG-ii.,LLt V.GL f 6i ow c.m.,* TENANT� BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET > SV � S\A CITY v v STATE \A\a. ZIP g ,0 OWNER PHONE: 2-1'k .1 1 4 - 221'1S2- OWNER EMAIL: CONTRACTOR NAME: Pia-A- r(\ (1 �`� 1,0i &I“-A-)0\S CONTRACTOR ADDRESS: `1 STREET f O ��(O CITY M.A.�r�'►> 9 M LC STATE NA_ I zip 9 2L D CONTRACTOR PHONE: �j(_Q() •Le -•--8 c1!'� CJ CONTRACTOR EMAIL: I(-). --0 (Z f)A. �� U kka_ ►1 �> CSD6A CONTRACTOR LICENSE#(REQUIRED): f C%� 1 �l,b 2_ h CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6. "> PRIMARY CONTACT: 0 OWNER (-CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 31,0 . LPc•.1590 ju,tuu baiikAILLA71 CONTACT EMAIL: 1 yr (f `'cM kgGL."I "�r , (►AW-) BUILDING INFORMATION (� ((^^ f DC Existing Use of Building: Contract Price of Work: $ liJ 1 .. Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: -Pcakt,i, ‘C/k P- aoy\..4t;t+-ioyl 1 +I) j2,) ,k .-k-) ,,\ -6,,,(2-KiL,0_,_, ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture 1 Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures 1 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 Ventilatior 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 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, ••I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. %tiff \ki -P03.- DS City of Everett Official Use Only 51 l l PEI- ID✓r `DS Owne Authorized Agent Signature ate (Revised 10/10/2018)