6429 BROADWAY 2020-01-21 - Laserfiche WebLink

elPf/Sp/-'—_,—d. PERMIT APPLICATIO• BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION vit CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 6( L.{ 7( gr-c) �w PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision PI'A) `L' C r of No. - '(attach copy of long legal description) CONTACT INFORMATION OWNER NAME: (712041) g Ql f'c, p...,..4, TENANT NAME(If Commercial): A,)0-74 e_ OWNER MAILING ADDRESS: STREET 6 q 2,4 6 r a CIN . QJ t J STATE A)A ZIP crA2 'j OWNER PHONE: (?&o) 22 ( — 36 g cl OWNER EMAIL: je g /O G g e •�YY7YA.e( (C CONTRACTOR NAME: 0 c IN U€Je_ CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: AOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: &r.,,-, CONTACT PHONE( O) 2 2q- f? 6 2 J 4 J - 5I•f7'b(l I ' J r Aw".-(1- CONTACT EMAIL: e.5-1–u-`7(® 6' ( 114' I tieg:)..r'( BUILDING PERMIT APPLICATION Existing Use of Building: 5 'Ii /C c ec,,„c icAContract Price of Work:$ /. O frt Proposed Use of Building: 5 j„)j le_ �j k,•n'r (Li Heat Source: ❑Gas ❑Electric ❑Other Building Type: OSFR-Detached ❑SFR-AttachedDuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition UtRemodel ` Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: n �P C ) - -rn tg c r`l ,' „f S l N 2 'NA)c4rt-t(; ",r‘s:Due-7,(c. 3 Ardelc I•c)als ASSOCIATED BUILDING PERMIT#(if applicable): 7? M f U J'1- ( MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New_ Addn _Alteration _Repair Type of Project: _New Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC–Air Handling Units Heat Pump J Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler / Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: / Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water I 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only OP / PERMIT# r Cwc710— Wil Ow = • orized Agent Signature Date (Revised 9/23/2016) (1)