6623 HIGHLAND DR 2020-06-17 - Laserfiche WebLink

OLT PERMIT APPLICATION BUILDINu i MECHANICAL/ PLUMBING /SIGN I JI RINKLER/ 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) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: (e6 Z 1j,3Vt/o. a PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 9b& ter, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 64 1..., L,EGQ L Jl^ CITY �j tere''Jl- STATE (j>� 3 ZIP 9X OWNER PHONE: tet. Z3 5-3'73 I OWNER EMAIL: 5c.1vt yf-oist rf ^ �//)1I✓Vt.{•Cr.M CONTRACTOR NAME: r—Gl1 ( � oo4160 t 1 CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: „Ce'7 -6'80 -2•`lz3 CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: riOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: 67i.:-W-- CONTACT PHONE: Zbc, —Z 3 S - 367 12-D.;ec 4— (i.- CONTACT EMAIL: 5,,(d l y ro.� c/r: %wP 5 nn...; .6-1# 't BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: DGas ❑Electric DOther Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: _ ❑Commercial Dlndustrial Type of Project: ❑New DAddition DRemodel DRepair DTA. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: G(oldil-1-1 plot/Kt,- it, re-- -t" CPVV'u - - ?JI- Covvki-+. 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 ofixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Q Toilet Backflow Preventer(Inside Bldg) Forced AiCSys,tems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration I Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups' Other: Clothes Washer Medical Gas Range/od Water Heater Other: Exhar4st Fan 4 Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM (Number 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.l 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 State Contractors Law 18.27 RCW and 296.200A WAC. / � City of Everett Official Use Only I �� , Pt7/2/z1//c S01 CA , :fir,,AT•or;ed A.: 11 :ignature Date (Revised 5/20/2016)