8215 BROADWAY 2020-04-01 - Laserfiche WebLink

. ^ 12 PERMIT APPLICATION BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION EVERETTCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)evoretteps@ovorettwa.gov I www.everettwa.gov/parrnits (Blue or Black Ink Ont Please PROJECT SITE INFORMATION PROJECT SITE ADDRESS: S.7..1 c t3E0A p CLQ s, PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: r./(--1:-.."- c C.-,..--72 ti/ ....G5 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STIIEET 1?2-4 S 1- 1?0,f1bti jPitil CITY evozerr- STATE (a4 . ZIP g -e0:7 OWNER PHONE: (1-7Z5) 4410- ltkl/Z. OWNER EMAIL: A-JAI! t'. CONTRACTOR NAME: CIJOZ6/leep 6:478. 1-(09-r,i Ae D . . CONTRACTOR ADDRESS: STREET .2...1 242 PA (./. 0-t tC- 1 CITY Outtr- . STATE LtAik, ZIP wan CONTRACTOR PHONE: ti4-zs-j 2S2 - g/lik CONTRACTOR EMAIL: 1 $,i.- (0. .e..5'Sill '-t.-'4.' C 0 11,4 CONTRACTOR LICENSE#(REQUIRED): .:•‘,/e72 6 5-sm.? (-Jr-- CITY OF EVERETT BUSINESS LICENSE NREQUIREM: 60-7q5r PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: i CONTACT PHONE:( 42c) 5-zyg t.5279-(-6) CONTACT EMAIL: CONA- - INIMINS.0111•11•1111•On BUILDING INFORMATION Existing Use of Building:A u-ft) -1piickrap Contract Price of Work:$ (Z S60. Et" Proposed Use of Building: Heat Source: IGas DElectric DOther BUILDING USE: CISFR OTownhause ODuplex EJADU OMulti-Family-#Units: ttommerolal DAccessory Structure Type of Project: EiNew DAddition ORemodel ORepair DTA. DSign OSprInkler ODemolition OChange of Use DESCRIPTION OF WORK: 0 I\Ca", i 0-e e- Repkoz. q 4-4 -a +c- A/g- !VA-4D/r7 62064--c i,-(' I 5 'I o cAreT 9I\_., 1-q&-- q4.-040,9d fAel- op--?,>1.4 r tell il'' ASSOCIATED BUILDING PERMIT# if ap.licable: MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture List of Fixtures List of Fixtures List of Fixtures List of Fixtures Count Count Count Count - . ( NC-Air Handling Units Gas Piping Backflow Preventer(inside Bldg) Shower,Tub,or Combo Boller 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 Ventilatior 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) j 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 1 -No.of Heads _ ,.._ Chemical Suppression System I No.of Heads •IIMIII.IIIIMIMMIPIPIIIIIII. 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 Buikiing Official before being authorized under any circumstance.I am the owner,or/em 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 298.200A WAC. City of Everett Official Use Only PERMI I Owner/Authorlzed Agent Signature Date (Revised 10/10/2018)