10210 EVERGREEN WAY 2020-03-06 - Laserfiche WebLink

I' PERMIT APPLICATI friliffrBUILDING I MECHANICAL/ PLUMBING/SIGMIRINKLER/DEMOLITION � - CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION rp v�y PROJECT SITE ADDRESS: l 0 2.1 rpei, ,ti W ( -oJ1PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision L6f No. (attach copy of long legal description) m CONTACT INFORMATION OWNER NAME: 2 G( )4c t�j TENANT�/ f � BUSINESS NAME(Commercial): Lx. > 1.i cf OWNER MAILING ADDRESS: STREET –0 0 1 g �J �� .c) �ry CITY y vi..wOd c STATE t.CJ g\ ZIP a C'/b 31-- OWNER PHONE: CM 2-5) 1 Ci (2-1 45 OWNER EMAIL: )4Q1) WI 0 "Sap hizi-cls- kyr.( CONTRACTOR NAME: 693-{-t .A._ -ac( (L 0(V-kC.P CONTRACTOR ADDRESS: STREET l Ilk LQ ek.)'_ Li, i j `a_iL,4 --4 2Ctc1 CITY 1"'�l( (- J\,c , STATE e,� \ ZIP 80 34 CONTRACTOR PHONE: (-12,%-\93-0-34-1. 3 CONTRACTOR EMAIL: thepFPrZ.00P41W►2 Vete...J.65c ' CONTRACTOR LICENSE#(REQUIRED): 0 PIC l" f g6S'QS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER E CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CL 12 ) gi d _3/ i 31 �aA•U3 c-P6� Z-� CONTACT EMAIL: 30 p C'SLU 0 't`/l( ( pkt(A) . (DPI BUILDING INFORMATION Existing Use of Building: ti-p'k' _ Contract Price of Work:$ e Proposed Use of Building: kACTI- Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU OMulti-Family-#Units: Ieommercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign OSprinkler (❑Demolition ❑Change of Use DESCRIPTION OF WORK: G t vt,s4 2l vb S -{Q ( —e (2c it- ASSOCIATED BUILDING PERMIT#(if applicable): ,8 I 1 '-0 I CD 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) IS 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 bef. -being auth ri ed un.er 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 wit - .tate .ntrc ,rs La 18.27 RCW and 296.200A WAC. City of Everett Official Use Only ! 3 4 r P � r(ct 03 -000e Owner/• th• iz:• •_e,,Si..: re r te� (Revised 10/10/2018)