7911 40TH AVE W 2020-06-18 - Laserfiche WebLink

IIIIII ''OSETT PERMIT APPLICATIO II II BUILDING TMECHANICAL I PLUMBING I SIGN I bPkINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES J 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) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 3^9'll 1/0t if VE W (eh/O EO,Ulf 982,76)1 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: aubtulte SLP TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /CZI s- 12,1 v-17ifirt, ME CITY /3014STATE AM- ZIP f 801/ OWNER PHONE: 106-37? (a Z OWNER EMAIL: ref a SO eut4 60711 CONTRACTOR NAME: 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: Zolc-57 p)Qii8 Russ /`USS Oatul� lls�S'I��tCONTACT EMAIL: evici' elm�/ �t CO7YL BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ GA!).41V-* 'D i.°D-^" Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: ❑New DAddition ❑Remodel ❑Repaiir ❑T..I. ❑Sign ❑�Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK:/ruts/b& ��/ e/ /n laAmi /p i W`' 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 #o #of List of Fixtures List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C— Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air ' stems Unit Heater :.thtub Urinal Gas Piping Boiler Lay. .ry. (Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sin' : Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: 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. he granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official b-ore being auth' ed 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 he St-e C'nt:, ors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only i . %'.a'''' /ie PERMIT# Ile•ut ize•Agen Ignature Date (Revised 9/23/2016) (iii )