2117 5TH ST 2020-05-21 - Laserfiche WebLink

I 4.677- PERMIT APPLICATION BUILDING I MECHANICAL/ PLUMBING I SIGN I 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 I www.everettwa.gov/permits PROJECT SITE INFORMATION 01-PROJECT SITE ADDRESS: ....ice �vCT�� PROPERTY TAX#: aid'7 5r-. LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION -y OWNER NAME: ,J er re y b, L -& TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2,/i 7 5 s t-- CITY E✓e-TE TT_ tA)A- . STATE w A ZIP 9 s 2,0 i OWNER PHONE: 2C e. ._ �i14l-1,Vq of OWNER EMAIL: „)a l es ej (or CSAvi/N i L , t #c-( CONTRACTOR NAME: ® W,+Jeit - �c-notC. CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Z G t Co UW- Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family#of Units: ❑Commercial 0 Industrial Type of Project: ❑New ❑Addition CI Remodel ❑Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: K t-r c.4.v-+3TzeA,,,..,,,9„ ( _ AL,v Re ser c,x.- -r I i p—'Z. (2.€47 10_,e.,,Q Vater I (L,.vq 'X e (�.tt✓cr w zF /0.ece) , ,d�.etabe42 13r�r-�-i, exh�.vS , A .�.Q d4L-cec1 C 1 -, Q.'4s 5 ;' ' 'iiu;LT Dom- ( /2i,0eV Gc00,412 ° 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 I Heat Pump kAil 1 Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler ItriA 1 Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove _ Kitchen Sink&Disposal _ Grease Trap _ i Gas Range '-d A Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas V Range Hood yttil. Water Heater Other: I Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads s 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 a 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 1 Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this properly to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAG. r City of Everett Official Use Only �J �Jr ' PERMIT#f�/`O" (ltY DV1 I 411111/A �Ag• inature Date (Revised 10/12/2015) ,