4624 HARBOR LN 2020-01-29 - Laserfiche WebLink

PERMIT APPLICATION BUILDINGCHANICAL/PLUMBING/SIGN/—MNKLER/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: 4(o24 i-tAgBoi2 LAI0C PROPERTY TAX#: ( d4{'i71ddQ160(00i LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: "74 5Ro IN TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5AM CIN STATE ZIP OWNER PHONE: 408 311 5 A S-5- OWNER EMAIL: IIMBgotiNJL}/ANDD,Com CONTRACTOR NAME: S - ®�vm� CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: OOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: cp.16t1 F M icy er4C-E Contract Price of Wo :$ O�� Proposed Use of Building: SAMA Heat Source: ❑Gas e her Building Type: DtSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.i. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: l mar-) oc' GAS Pi'i"a j"a? NoT w ivrot o reg-7 FU Tisk CJtS P-I't int:. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT,APPLICATION`` PLUMBING PERMIT"APPLICATION , Type of Project: New_ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair Fixtures List of Fixtures Ffxtu es List of Fixtures Fig List of Fixtures esFtxtu of List of Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal `x Gas Piping X Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease-Trap X 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 IND.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 oroaerty to aerform 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 PERMIT 2/ 2 N,A. -0 2 ! Q lcl Owner/Authorized Agent Signature Date (Revised 9/23/2016)