515 VERALENE WAY SW 2020-04-02 - Laserfiche WebLink

PERMIT APPLICATIO* I LI BUILDING ECHANICAL/ PLUMBING/SIGN I OPRINKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue ter Black ink Only,Pleasej: PRO44,-OLTE:; NFORMATIOi!il,.z.. , .,. ... .y .`._.>,.... t z., . .. ....v... ..2 .., PROJECT SITE ADDRESS: 5 y at r Svo PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) . ,OWNER NAME: }"a, on ohs TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET( CITY FA)-e�,e---114c— STATE lA..) ZIP `U 0- OWNER PHONE: L-l. OWNER EMAIL: O S P LCAJ.D‘re.k. ck'fY1Gt,l 1. m CONTRACTOR NAME: Ol CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): JOLTY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: • Existing Use of Building: Contract Price of Work:lit Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION WORK: % nrl V\ SE_) ASSOCIATED BUILDING PERMIT#(if applicable): t . MERFHANICALPERMITA',PJJCAT#i :*, '.. 0LUMB1N PER I1 PUCAT1OI0'.. i FixtureFixture Fixture Count List of Fixtures C°r 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 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) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER 140:00RESSION,$YS`'1"E I[" GSewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads. ACKNOWLEDGEMENT:1 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.tam the owner,or lam authorized by the owner of this property to perform the work for which application is made, and I co .ly with the State Contract.s Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 1 '� 't� 1 (go7-00 ( 0 n: /Autho '--d Agent Signet Date (Revised 4/15/2019)