10112 19TH PL W 2020-05-18 - Laserfiche WebLink

IT APPLICATIO 00141p, - BUILDING J MECHANICALS/PLUMBING I SIGN !SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 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: /Of/r2 1 q Pi• (dV PROPERTY TAX#: OQFpq 13 ofo4t,0 w(70 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Al ifbek A • d cue- TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET /6 f/Z ( '(f(2' PL. W • Q�} _ �/ CITY L!�V- r STATE j'/(f/I�,/� ZIP / ii).2c q _ OWNER PHONE: "!&J — /6 T 0 OWNER EMAIL: /174/e/�/�C.�:ti6 to 3 lw I Cit ad .6.411 CONTRACTOR NAME: Owl/a*-- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: / r�iy4J CONTACT PHONE: q 2 c --Z,/'c -- C" 7 5 J. / Z — /-2CONTACT EMAIL: 0Ui¢ "��. /, 4TO/UC� /2a G Nov...a , C'bL1 BUILDING INFORMATION Existing Use of Building: I4or ?moi Sfii, Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ErSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial gQccessory Structure Type of Project: ONew ❑Addition ❑Remoddel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WOR / r red Deif< .,— �1(1q 7/N6 Pi/3'V 749t WI' P/ZD F /78 6'1'14 RR- eo,i/21f. d / ; 4/ 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 NC–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 Ventilation 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/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 befo- •-ing- .rrz-•under-• 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 ",•rjh= . -•C.ntrac•s Law 18. ,RCW and 296.200A WAC. e,Ci9ty of Everett Official Use Only ,�,. �/7 /g— PERMIT#6 1lf (1'04— ;lf%� O- net/Au horized •.ent Iture Date (Revised 10/10/2018) • a