2332 119TH PL SE 2020-02-25 - Laserfiche WebLink

OLTPERMIT APPLICATION BUILDING I MECHANICAL/ PLUMBING I SIGN I SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION... PROJECT SITE ADDRESq:, PROPERTY TAX#: .'332 - 11ci -, Pk se co erZ-) 0000 2 on LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION; 1 OWNER NAME: CA p,vd't r. 0.0' 1 %......p elAc TENANT NAME(If Commercial): —� OWNER MAILING ADDRESS: STREET •, -.2,-' 2, _ it CTS P \ S C--- CRY =CRY Et.ye-,f'.e.tt STATE `gi 6 71P OWNER PHONE: LA Z5._._.Z1.5..`_ —117.0...... OWNER EMAIL: CONTRACTOR NAME: K a k 14A.e L1 H eg i Tl q CONTRACTOR ADDRESS: STREET Cl o'Z 5 %J, Vv►.Pn d a L1/41 (..&Ice 0 c 1 CITY &flee- ZI w.0.LAI L. STATE U r7 ft- ZIP C/8 i-cr o CONTRACTOR EMAIL: CONTRACTOR PHONE:3C00. 5(0 S. O((0 7 CONTRACTOR LICENSE#(REQUIRED):�,kt•-YN e t^f X4,4, P Li CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)432- -3 0,9 PRIMARY CONTACT: Ixf OWNER ❑ CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Lt Z c- 'Z,.—,' 7-)—) : C\ ,._U(1 ti t: > �_ l CONTACT EMAIL: BUMPING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 2.0 0 O., )-(--)' Proposed Use of Building: Heat Source: ❑Gas DElectric DOther Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New DAddition DRemodel El Repair DT.1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ':'6. ‘A.C( fv-- - ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL-c_ ` PLUiVIBING,,,PERMIT APPLICATION ! ( Type of Project: New Addn _Alteration Repair Type of Project: _New _Adds Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures i A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) (. Forced Air Systems Unit Heater 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 ii Range Hood Water Heater Other: II Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKL`EEit/:SUPPRESSION SYSTEM_. , 5.,= H Number 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,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 296.20011 WAC. g City of Everett Official Use Only (� r / IPERO1 � Owner/Authorized Agent Signat re ate (Revised 10/1212015) k