6119 COMMERCIAL AVE 2020-02-06 - Laserfiche WebLink

44-77- PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER/ DEMOLITION 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: ( '// 1.r1/yl/�1E2clALr _ PROPERTY TAX#:QQ /'-/9O//Ui 701 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 5,40ve' 5j4,4-Le} TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET (O//-f C rrim etzG4,4-c__ 411P CITY C✓ fl 77 STATE LA)A--- ZIP L r2.0_3 0_3 OWNER PHONE: I42 -77Gr-ZZZ-7 OWNER EMAIL: CONTRACTOR NAME: DA.y d-tJrTE PLurriz1,06_ d-HEAT7A) - CONTRACTOR ADDRESS: STREET /66 1 L /3.2 40,p,6„0 CITY 1.„,yN,k)waD.0 STATE (AJ A- ZIP 9g-03 7 CONTRACTOR PHONE: 1-1Z9--77c 6Li4.V CONTRACTOR EMAIL: gRYA.\I Cg) DAtIrAAI DIv/1 •Ater CONTRACTOR LICENSE#(REQUIRED):p,- ' pr/gL/L/, CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):QJ£(74l PRIMARY CONTACT: 0 OWNER OCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: p, at-tic-F. CONTACT PHONE: iiZ5-115-(oLj�[oLi 3Pfi f'{�a' CONTACT EMAIL: B6 ?PIJ (.JDA h9/1//Te; , ,IJ..e-r BUILDING PERMIT APPLICATION � xisting Use of Building: Contract Price of Work:$ (a/kZ 1 GQ i roposed Use of Building: Heat Source: ❑Gas DElectric ❑Other_ Building Type: ❑SFR-Detached MFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: �i,/,STAC,Gf+%_ gonLt4 v 6 Farr__ 4 d-e,") 6,1, cDitA ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration Repair Type of Project: _New _Addn XAlteration _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 PumpToilet - Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater j Bathtub Urinal Gas Piping Boiler i Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration 1 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 ' No. of Heads L— 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 . irrent 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 -_Jilding 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 7. / // p Virii( PE T t s 0c _ ca 4_, ........„Owner/�1iS`orized Agent Signature • Date (Revised 9/23/2016)