10515 30TH DR SE 2020-02-24 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / 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 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: 1 os-1s- sot` - SCQx-t''EwA clog PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: t2,Q-rA_1 4 A,M�ISA Ntx py TENANT BUSINESS NAME(Commercial): ,1!A OWNER MAILING ADDRESS: STREET 105k S— 3or' AA- SE CITY ak.`R-Err STATE WA ZIP 98207 OWNER PHONE:(4z,5) 3h9- �se� OWNER EMAIL: CONTRACTOR NAME: Cpri- KexTT-.de CONTRACTOR ADDRESS: STREET 2pZ,2,1 (0"1' A t.: CITY tkud+.46 1 .4 STATE WA ZIP 98U3 CONTRACTOR PHONE:.r ) t435—-ifga'I CONTRACTOR EMAIL: r\IFnra CtazyF+FAT�n/� G. CaM CONTRACTOR LICENSE#(REQUIRED): C J?y 14<A4 02_0m CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):OZl// ,i PRIMARY CONTACT: 0 OWNER ID CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: j��,.1 * cct• CONTACT PHONE:C.1.f2 1 q�3-4517 (C CONTACT EMAIL: <,Pvy�;.c�g,.t.('Cp1LJ Gow.rL.Colvt BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $ Proposed Use of Building: Heat Source: OGas DElectric ❑Other BUILDING USE: QSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition .Remodel ❑Repair ❑T.1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: co7.y NGATINC, ,ir.dc, 46, D.E extStyP (,AS Fwt,,.iAc..J1 Aig CoAANTIoN v -r Nar wAr+; 7 A • 2*.IQL* .E. (.4i-V i % NAT: (pAs Fw."4Ato, 13 SF a[_ A/,t COMOIVON v' SZ) G„e[.L/w Nor c..Nrtn_ 1/b A-rea ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count CList of Fixtures punt 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 SystemNo.of Heads Chemical Suppression System 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.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# • 5/r62/Zar .M,ca OS -CSS q Owner/A orized Agent Signature Date (Revised 10/10/2018)