5503 COLBY AVE 2020-05-05 - 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 I 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: 5.-5() 3 C49/6/� �/i(.�_ PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision `J Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: (itri / L . 11D TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3602 [f e 14-1.4-e_ . �=7i(�/i✓.O- -"I,l 62-0/ �J CITY Cvvr �,0' STATE IN/ i ZIP ! FZI)/ OWNER PHONE: 4e1,,1--al /0 -3 46 , OWNER EMAIL: 6('L)C V7 6 GL X. eQ�"�,0,arow. CONTRACTOR NAME: Da,64.Q_ (,(Jt tk(f Yl `e., .- UV a,k t jC L.c.5 ruL,CA-1,D'V\ CONTRACTOR ADDRESS: STREET` _ P& (?C I I.(a CITY kt�t.lC.e, 6"4--.e. CAA./5 STATE W ZIP -\ p Z5 8 CONTRACTOR PHONE: 4S-3 97-0 y69 U CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): OW I 0 M.U) rL$9 P 8 CITY OF EVERETT BUSINESS LICENSE#(REQUI ED): 45(5 PRIMARY CONTACT: 12rOWNER 0 CONTRACTOR 0 OTHER(Please Specify) 6� CONTACT NAME: CONTACT PHONE: Lza a-./'b--3 fs'6 0a/rei_.67. /p (3-cFF-CiA.1;, CONTACT EMAIL: QaXylouX vailap, cd BUILDING PERMIT APPLICATION Existing Use of Building: AI -C_ Contract Price of ork:$ f3 Li 1 p©C) Proposed Use of Building:6 2-'i-Apv -l-Chirf>Cy-t- Heat Source: Gas f lectric ❑Other Building Type: ❑ C. SFR-Detached SFR-Attached/ ❑Duplex ❑Multi-Family=#of Units: Commercial ❑Industrial Type of Project: ❑New RAddition DRemodel El Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: /Vet() ,o-F 0--,-, ea- ge . /Wc/ ( r7 +. Cor�.v 4 e 5 t'Lv..a �` "Ipc,v'* kc, L+ "° ,-.0,,,, l 90,4-a4 i w,.,,.,r.�.0 raho o.�....a e- e.,.,,,, 5 L 4- ASSOCIATED BUILDING PERMIT#(if applicable): L0."2& o %J 'c!! W\ 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 NC-Air Handling Units Heat Pump ) Toilet Backflow Preventer(Inside Bldg) Forced Air Systems i Unit Heater Bathtub Urinal Gas Piping Boiler I Lavatory(Wash Basin) Drinking Fountain I Water Heater Refrigeration I 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 I. Water Heater Other: I 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 Law 18.27 RCW and 296.200A WAC. 9 I y (� \ City of Everett Official Use Only ACX X • / � _ PEF3P� '—� Owner/Authorized Agent Signature Date (Revised 9/23/16)