10626 WASHINGTON WAY 2020-04-03 - Laserfiche WebLink

IIII PERMIT APPLICATION IIIIII BUILDIN W MECHANICAL/ PLUMBING /SIGN /.MPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 1114-77 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: /O(Z C 109, 11,14/C-76/0CQ4Y L-y/61 /`qg 0 PROPERTY TAX#: OO5 Z5OOOI /600 LEGAL for new construction: Short Plat/subdivision 1 4 ICHO /A/'7& 'Cl if(Lot No.((6 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Dot°r-j v j.`/I4[& TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /06 Z 6 (Ai A),5--/1„ -< a/V W4 V CITY 6-v t i / 7 STATE LAIA-r ZIP / 20 OWNER PHONE: sbS60_z I OWNER EMAIL: _ CONTRACTOR NAME: Oj 7-/Off C= CONSY�t4 " L_ fOAI L CONTRACTOR ADDRESS: STREET ( 3 /q 0 (_' CITY 4 )N L./E Ai legle0t STATE /, ZIP Z 6 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED):/nOk C lIC L (43 /'41 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR OTHER(Please Specify) j 0AT CONTACT NAME: CONTACT PHONE: L 6//i W PJ 0 A CONTACT EMAIL: sot-OK/15 009-44 j `'!00 'c, BUILDING PERMIT APPLICATION rr Existing Use of Building: Contract Price of Work:$ 52-L2-0(Q.D% Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family#of Units: El Commercial ❑Industrial Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition OChange of Use DESCRIPTION OF WORK: ,t:t )tr �� yr R6 / 00" /4 (0/(// ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New _ Addn Alteration _Repair Type of Project: _New Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump f Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater / Bathtub Urinal Gas Piping Boiler / Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: / Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER`/SUPPRESSION SYSTEM Chemical or Water I 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 L-w 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT ' S ( 0 y-r'Authorized Agent Sign. re Date (Revised 9/23/2016)