332 MADISON ST B 2020-05-22 - Laserfiche WebLink

NNE PERMIT APPLICATIO i , I la BUILDING / MECHANICAL/ PLUMBING /SIGN 1 SPRINKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: .�,a J'1nkbISGm .e;-1- PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: J eAMS 14,1/408,\A„,1.1 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET /� CITY STATE ZIP OWNER PHONE: 26 b 840 9is OWNER EMAIL: CONTRACTOR NAME: as fY\ DIIJ NI ,Sbj 4.i f e. . L.ijal,(i i A 6 CONTRACTOR ADDRESS: STREET to' i7J r-D/47-4 5'- Lt) CITY /714TGigf ,'j4/7{- STATE /04 ZIP 9/9%)L/3 aril CONTRACTOR PHONE: CONTRACTOR EMAIL: // /'Fi77/2 3 J/N1 ti,6(.f ELOEi. CONTRACTOR LICENSE#(REQUIRED): j1 M -S,3?el 83 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): / PRIMARY CONTACT: 0 OWNER XCONTRACTOR 0 OTHER(Please Specify) CONTACT� NAME: , CONTACT PHONE: � z O 713 QS S "7 ' ) i C LIA-E I 1\1\.14..i-E--1-T-1 CONTACT EMAIL: �k----i i0 `moi ev, .bntibf \E/2,( 0;\a BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ 73 con.`f Proposed Use of Building: Heat Source: OGas 0 Electric ❑Other BUILDING USE: ,SFR ❑Townhouse 0 Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ARemodel Y ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: �?�ptAcc i371 PAG 1,6417-E I? ti AES AAt.D L) LI)4ES 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) I ✓Shower,Tub,or Combo Boiler Gas Range l ✓Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer - Heat Pump&Ductless I ✓Dishwasher 2, v* Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation '"1"l &Dfain.� C� i Toilet Exhaust Hood(Type I) (Not Heat/AC system) . Hose Bibb Urinal Exhaust Hood(Type II) Water Heater rcep`for-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil ratervice(behind meter) Forced Air Systems Other: Medical Gas •.. cValyes or Fixtures Gas Fireplace/Insert/Log Roof Drains r1 Water Heaterm 4r1 SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump 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 Sta e Contrac.rs Law 1 27 RCW-nd 296.200A WAC. / City of Everett Official Use Only PERMIT# ii✓, Id �� _)/4 c.. 00 --05 --- Owner/Autho zed Agent .,igna re Date (Revised 4/15/2019) ( 3/31 l