4011 FEDERAL AVE 2020-02-07 - Laserfiche WebLink

PERMIT APPLICATI(= 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 (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue'tr,Black Ink,OitPlease} .PROJECT,SITEINFOR AtION PROJECT SITE ADDRESS: 10// ,,l e riot( iv,, , t v e.r�.0- PROPERTY TAX#: 290530063 0 4/6 00 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) .. CONTACT INFORMATIOI+ OWNER NAME: iCAN n rA0.rV%e\ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET q I I Ne d to ree.( A t/.e__ CITY er yr it-e•-t-F STATE (,J f- ZIP 987,0/ OWNER PHONE: yZ.S— 33 9 0,2..5-3 OWNER EMAIL:,01,n. m.004.irr,0, L3 clo c.k s. conn CONTRACTOR NAME: 0 /A CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: in OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: $EE AQ dye- CONTACT EMAIL: 'BUl OlNG PERMIT APPLICATION � <; , . Existing Use of Building: Z e_s;d.•,,,,,{,1 j C s Fc) Contract Price of Work:$ 0/A Proposed Use of Building: —Z,G1i 4..,,.L;` I (5'F ) Heat Source: OGas ❑Electric ❑Other Building Type: USFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New DAddition iyi Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK• R. ` ry 1 t1 \ I }IA{- f4.s1•-4. *I irk e,rr�o V a O � r a. �.s a s Wt ov t n� e: t c r i c a ��* 6 s.dreotn 0 Ltpc�a\-:n 60 . �‘x'1'V.eess 11.1c1. or- tike C' j i- sink +\,;Lf� IrTi-C\ke:LT` ok r.•e�J t-1 1(1% .,eue►.%S1 L4 4.,... e.r?Or o.s Q.Nroortata ASSOCIATED BUILDING PERMIT#(if applicable): 'MECHANIC* PERMIT APPLICATION'; _' PLUMBINia 01.tNi or APPLICATfQN 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 A/C—Air Handling Units Heat Pump r Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater l 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 I''`SUPPRESSION SYSTEM: Chemical or Water ' 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/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only oJno��nq% 741/40,7io/7 PERMIT# /-J Ow er/ uthorized Agent Si nature Date (Revised 9/23/2016)