2603 E GRAND AVE 2020-03-06 - Laserfiche WebLink

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: 2 t 03 E 6,rct n at 4,/e PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: St7e-t not I'lie t'_on s 4-, TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 2-Z 0,3 tg \.e-r4w4'( R<7 A CITY 1-C1d P� S - St iA/STATE A ZIP 9 - Z OWNER PHONE: Lc, -- "7'k S SI OWNER EMAIL: 1 I des fr,.. G of+'>IOti f.c oris CONTRACTOR NAME: `1-e+ P &(1-vl j:t� �t CONTRACTOR ADDRESS: STREET 1l?�o1 1751e Qi/U s - ✓ 1 PL PL Sobo CITY ntiA N(Dv I' Le/ STATE tja ZIP C21 6 2J CONTRACTOR PHONE: 425— 3161 "l ( CONT CTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): 6O3-47-3--7-'to CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): bstf (9 2 PRIMARY CONTACT: 14 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 2_04, 7V,- � S clod'\ CONTACT EMAIL: BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ 4000 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: titSFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair CIT.'. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: KesFe t e ASSOCIATED BUILDING PERMIT#(if applicable): 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) ) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher 2. Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop I Exhaust Fans(Residential) Commercial Ventilation Floor Drain j Toilet Exhaust Hood(Type I) (Not Heat/AC system) I 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 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 c21 PERMIT# v ,q,9 ,--00--z i Owner/Authorized Agent Signature Date (Revised 10/10/2018)