9010 4TH AVE W 2020-06-15 - Laserfiche WebLink

(gir PERMIT APPLICATION BUILDING / MECHANICAL I PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (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) 4/)% PROJECTSITEINFORMATION PROJECT SITE ADDRESS: 6/I 0 /0 LI 7 � - W • PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision _ Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Ii-\---A ( V By--a j TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 61 .?)--2., 7 i Nit by CITY vog/y il c\A \ \] STATE 1,kin. ZIP 4 7---1.(] OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: v✓v/iW 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 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING INFORMATION c�LF; Existing Use of Building: Contract Price of Work: $ 0• Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition OChange of Use DESCRIPTION OF WORK: (IcAiv o A cc s coay, ASSOCIATED BUILDING PERMIT#(if applicable): (t, ( (61-7_,-0(Y1 MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture List of Fixtures List of Fixtures List of Fixtures List of Fixtures Count Count Count Count A/C—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 before being authorized under an circumstance.t am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I com.ly with the State Contractors Law 18.2 'CW and 296.200A WAC. City of Everett Official Use Only ( \ \. \� \ tf6 PERfW�T#'n� D —V a—i • ner/Au orizs. gent—"gn ure ``\ Dae (Revised 10/10/2018)