10317 HOLLY DR 2020-03-06 - Laserfiche WebLink

PERMIT APPLICATION al BUILDING; iiaECHANICAL I PLUMBING /SIGN r bra RINKLER I DEMOLITION EVERETTCITY 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: t? 9 11-fl1.,L1 1/y� e-kI%1 fl (:)1-37,01-- PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: C.( �� Ps F\ ---ic, s-v.iiqe. TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET ( Q' ` 1 )‘/V'-(' p - CITY c,` Iii '' ' STATE ZIP NZ V y OWNER PHONE: '2 l: C 0 OWNER EMAIL: 4 -ii i L -C CONTRACTOR NAME: pi) (2/1— S.---0c2/6-. 4 C1' c&l 0, •�- L C._ CONTRACTORADDRESS: STREET ( it,C5 S ,-2,;,V9- 9- 9 (�X!7^U CITY ✓� STATE 1 A r ZIP'[ 'J 2 CONTRACTOR PHONE: 7 X15 4,o--57,.. n(L CONTRACTOR7 EMAIL: K& F �,1z .i_G) �Af-1(., ( CONTRACTOR LICENSE#(REQUIRED): 6 S f s) 1L- 77�9V2_CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6 0 9 4- PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ,-L-0 b r1�c ( -D-5."L /ten n n , tN-\(.O CONTACT EMAIL: l ry 1", - _- b c -E 1 E...)(`fit i i I L , cO r- 1, BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ 12-0 10 Proposed Use of Building: Heat Source: ❑Gas 0 Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse 0 Duplex ❑ADU 0 Multi-Family-#Units: OCommercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. OSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: / -, ASSOCIATED BUILDING PERMIT#(if applicable)*,Q 0 0�- ()IAD 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 Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain l 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;acrd loca!1 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 "cumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, (nd I comp #re State-Coit torsid 2 _RCWen967289 WAC. � City of Everett Official Use Only -.. PERMIT 1 9 1 Owner/Authorized Agent Signature Date (Revised 4/15/2019)