1630 OAKES AVE 2020-05-08 - Laserfiche WebLink

immi PERMIT APPLICATIOr BUILDING`➢ MECHANICAL / PLUMBING / SIGN I SPRINKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (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: / 4-,‘ 3 0 O < SS /IOC PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No.17-1 attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 'Dy/ZM /3 -t(-, TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET /6 3Z o -/C'lzf Ao, )� �� /� CITY V � STATE (�CA44 ZIP `?es / OWNER PHONE: 447.-— 30T._ 119 Z.7._ OWNER EMAIL: CONTRACTOR NAME: 6.0 4-4.A-- --(1 LT"(1 6.4(.2{Q,6-A .. Jt/C-) CONTRACTOR ADDRESS: STREET�3 e5 w --Ci�S L �r �� /LO. �j CITY �--Vf 444-040 U LY4"'h)% STATE ` ZIP qe�-'C/L— CONTRACTOR PHONE: 3 CO • :5-72_ ,-L' 79 q CONTRACTOR EMAIL: £ 9t ho,t /d 5- e. J �' � Cdt� CONTRACTOR LICENSE#(REQUIRED): QuKki_i G t j(<o 7 7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): `"12- I 05 PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: D`T`''q n y/ CONTACT PHONE: 360 S Z ,•- L{ E 7 f l`��y� CONTACT EMAIL:G7j j 6 0 1 1 d-&i' e, y cdi `c.--Cut BUILDING INFORMATION Existing Use of Building: 5'r rz, Contract Price of Work:$ 1/6// OGU Proposed Use of Building: 6-1. (,A611._ Heat Source: DGas DElectric DOther BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU OMulti-Family-#Units: ❑Commercial DAccessory Structure Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.I. DSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: c.6/lif raDLA-C CkJ Ott 0_ 2Cvr%Lc L(/' #C1 vi-C O pz7 C9ic" MuIi 6 if 4-14-64z :/1/4( 77i-(z Atrur! - y/ clic //-[,L .. ASSOCIATED BUILDING PERMIT#(if applicable): 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 was Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes ryer Heat Pump&Ductless Di washer Sink-R idential(kitchen,bath,bar) Duct ystem(Remodel) Refrigeration inking Fountain Sin tility,laundry,mop E aust Fans(Residential) Commercial Ventilation Floor Drain oilet xhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type 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 I 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,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. City of Everett Official Use Only tq 0_1 ...... ty-6 C-73: PERM Owner/Authorized Age Signature Date (Revised 4/15/2019) ��)