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1513 MCDOUGALL AVE 2020-06-05
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1513 MCDOUGALL AVE 2020-06-05
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6/5/2020 2:14:56 PM
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6/5/2020 2:14:32 PM
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Address Document
Street Name
MCDOUGALL AVE
Street Number
1513
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PERMIT APPLICATIO <br /> °11411111,ABUILDINECHANICAL/ PLUMBING /SIGN INKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue,or Black Ink Only Please) PROJECT SITE INFORMATION <br /> L <br /> PROJECT SITE ADDRESS: `5 k' `VA.t.... (E)..„.„-T,„....t...,--- PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Deal,,, ) 1,v I r J / Tt•- 4;4 ci PI kV-TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET l S`3 M cS)oV 94_(t -V-c_. <br /> �- <br /> CITY .. v-e f-C STATE \k/ ZIP C( 7O \ <br /> OWNER PHONE: (I 5 2 11//',40 OWNER EMAIL: Qcol,+`e74 t /aktre `co <br /> CONTRACTOR NAME: OW h-e-V'- <br /> CONTRACTOR ADDRE S. ST 4 yv..-G— 4c7 Above.- <br /> CITY <br /> boverCITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: iil OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: I CONTACT PHONE: \A--z, j - c(O 2GIC)c( <br /> Pocv„tlG 1 14 GW CtttCR CONTACT EMAIL: V c,ni cS 0,go -y411.0.0 ,Go v+,,,_ <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Pies f`c,(-Gv1C P Contract Price of Wcfl $_ O <br /> Proposed Use of Building: Ih ti'S<<0,t-r,Yt.t... Heat Source: ❑Gas El u . Other <br /> Building Type: ®SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: El New ®Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: k„ Ud n 1 �� <br /> a'1©G / l-G,.V1+�e. n vy {hOGi.,. o\VtCIe"I t <br /> zpP cokkke<S w,.-)-tx-- \4-ccuk r f e\0%ft- WetsTtr/ 0Vs,/Ir <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> A Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> j Clothes Dryer Hookups Other: $ Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> °L Exhaust Fan I Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I No.of Heads <br /> 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 <br /> 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 <br /> 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, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> pc - �� �7 I Prot, -- Q�_orized gent Signature Date (Revised 9/23/2016) <br />
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