5621 SEAHURST AVE 2020-01-30 - Laserfiche WebLink

PERMIT APPLICATIO+ BUILDING I 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: 10c9 1 -Sect h cj t s - 0e PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: '(1a`k u <(a CSG \cot/TENANT NAME(Commercial): OWNER MAILING ADDRESS:) STREET .� �GVIc CSC ` cr f+ CITY W f STATE q (-3 ZIP OWNER PHONE: - 3 SO ._s 2I S OWNER EMAIL: iccidana 2._e ltov(a.i ak\c , Wr ' CONTRACTOR NAME: Owr CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: jj OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING INFORMATION Existing Use of Building: S 9. Contract Price of Work:$_3--,0 0 o . 00 Proposed Use of Building: F K Heat Source: ,SGas trElectriC DOther BUILDING USE: %SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi Family-#Units: El Commercial ❑Accessory Structure Type of Project: El New ❑Addition ,Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use � ` DESCRIPTION OF WORK: Asu On CA.t1t1 SCo2-FI`�� E Si 'nG �c�-h `�.` 2tctf woet1. ntiei � r�r,.`e. >£ si F j ZI Ik 2x6 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 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 Ventilation 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/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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 16104_L\\ \, l wO Owner/Authorized Agent Signature Date (Revised 10/10/2018)