5116 HARBOR LN 2020-01-29 - Laserfiche WebLink

PERMIT APPLICATION I Ill BUILDING/MECHANICAL i PLUMBING 1 SIGN /SPRINKLER J DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 426-267-8857 I(E)everetteps .everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: t /`1 f R ' ..-4A-P: PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Ajok v /`- EA/ / TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS. STREET 51 l b /JI-/2i ' e I.4/C. (� CITY e(J -- e - STATE zvA r zip 4 cad OWNER PHONE: (9-2,,S--f ,�&,,,7 — 8g2:7 OWNER EMAIL: CONTRACTOR NAME: L✓(vZ 4 17 f .7<ci1; 1`f r A61 CONTRACTOR ADDRESS: STREET 142-0 'i A-C.t- , CITY �,1../d tA---- STATE t...4441 ZIP (12 CONTRACTOR PHONE:{ d Z c'-'2.—3(1 CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED):ev j j6 -0 2," -1Yt CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):000"7'q PRIMARY CONTACT: 0 OWNER [CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT�7� PHONE: /� l 62/ke---61�CONTACT EMAIL: ell ' w4,2,QSSrrl4lt,lea-1 an>7A BUILDING INFORMATION Existing Use of Building: Contract Price of Work:kit', SO O Proposed Use of Building: Heat Source: 17164S ©Electric ['Other BUILDING USE:$ FR ❑Townhouse ['Duplex OADU IMulti-Family-#Units: OCommerciat OAccessory Structure Type of Project: ONew DAddition ORemodel DRepair DT.I. ['Sign DSprinkler ODemolition OChange of Use DESCRIPTION Or WORK: ckA jt✓ el„cf- 1 64.,S, T t2 kf k ST! 4crit CO C.c(zO4 -Al ii- ClAevt"1`- .r "Nil t 2) U -'r.1 c,y 'fiSA'rfaT p4 ts$'i ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture List of Fixtures Mom List of Fixtures List of Fixtures List of Fixtures Count count Count Count NC 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(kltchen,bath,bar) Duct System(Remodel) 'Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilattor 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/ON Water Service(behind meter) 'Z... Forced Air Systems Other: ~ Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/LogRoof Drains ,Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression Systemo.orHeads Chemical Suppression System I 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.lam the owner,ort am authorized by the owner of this property to perform the work for which application is made, and f comply with the State Contractor. r n a27 RCW and 296.200A WAG. City of Everett Official Use Only / \‘ / _ - q PERMIT# 1/,7 On OwneriAuthorized Agent Signature Date (Revised 10/10/2018)