28 112TH ST SE 2020-05-22 - Laserfiche WebLink

gn- 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 I www.everettwa.gov/permits (Blue or Black Ink Only Please) ii,U4236 PROJECT SITE INFORMATION PROJECT SITE ADDRESS: L — 112. -54. e- PROPERTY TAX#: 005 7 34,0000'4300 LEGAL for new construction: Short Plat/subdivision 5';1vti' Lot No. Zt3 (attach copy of long legal description) 6c-cc- CONTACT INFORMATION OWNER NAME: pu c� Sok,-,„k-,„k TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Co e 2,32._ CITY N.;L<+y, L11,Vaz-4es C,L STATE ZIP 9 e sq OWNER PHONE: 40,5 _ 340 -- 65 Lei OWNER EMAIL: 'Sc-•w-E€ 1- ,A4� Pr L.. ,. ,cY- CONTRACTOR NAME: Ste_ r_S OLy,,rti X CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: DOWNER ❑CONTRACTOR OTHER(Please Specify) LY`GS j(\fL�x' ' CONTACT NAME: t.L)24,.-k.-r1 i.,rt t 51/4-✓e-9 r CONTACT PHONE: Lias -�S>v - .27 •=0 5 _ a t ` g CONTACT EMAIL: 3 c.5 C („lee-i:. ,,,e 5 •w BUILDING PERMIT APPLICATION n'n �� Existing Use of Building: h4Contract Price of Work: $ %\t7( 0 s Proposed Use of Building: .—e.5.ka.:;,,,vvi 4, Dot tAs Heat Source: ❑Gas DElectric ❑Other Building Type: j(SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: igIvew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: �I . ^ L cx i-rue)rwr, uf- vvLt. L`Y\14 w4 6-3 '"6":44t44- d.'i''"e.Lv(-'-' 1 a-c-:"-a to d %;4 i i-i fc S ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: VNew _ Addn Alteration _Repair Type of Project: •J New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump 3 Toilet Backflow Preventer(Inside Bldg) 'Z Forced Air Systems Unit Heater 2. Bathtub Urinal Gas Piping Boiler 8 Lavatory(Wash Basin) Drinking Fountain 2.. Water Heater Z- Refrigeration +-1 Shower Floor Drain Gas Fireplace Wood Stove L Kitchen Sink&Disposal Grease Trap '1 Gas Range Ducting Z Dishwasher Roof Drains 2 Clothes Dryer Hookups Other: 211 Clothes Washer Medical Gas 2- Range Hood y� Water Heater Other: 8 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, end-I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. (,,,._.. n PE RMI(1) City of Everett Official Use Only n OwnerlALt orlfed Aunt Si4re rat- (Revised 9/23/2016) 1