1239 52ND ST SE 2020-06-18 - Laserfiche WebLink

PERMIT APPLICATI I I I BUILDING I 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 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: \ '3 C 2- S" PROPERTY TAX#: 00 fQ '7- 00001. 101 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: I/QN cA-1,3 .1D(�, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET rt I D 2- -p0.-A\,mit-c. CITY A16"---11- rt-7 STATE 'L1_/7k ZIP Za ,'a! OWNER PHONE: 1-42(o 4-9 -7D e OWNER EMAIL: 1) � ' ' aotc& e, A14d° `-`' 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: CONTACT EMAIL: BUILDING PERMIT APPLICATI• -' Existing Use of Building: Contract Price of Wor•:$ '2°.`"'� Proposed Use of Building: 4E Heat Source: igiGas ❑Electric ❑O • Building Type: 1SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: •Commercial ❑Industrial Type of Project: ❑New ❑Addition (`'Remodel ❑Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: J p ieD[ — ® Ai Tse-&1O p. 3/ g irk® Det.._. ASSOCIATED BUILDING PERMIT# if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn )(Alteration repair Type of Project: _New Addn X,Alteration Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtu Fixtures Fixtures A/C-Air Handling Units Heat Pump 2. Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater ''Z, Bathtub Urinal Gas Piping Boiler I.-- Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration I Shower Floor Drain Gas Firepl- - Wood Stove Kitchen Sink&Disposal Grease Trap Gas R.•se Ducting Dishwasher Roof Drains Clo •-s Dryer Hookups Other: / 4 Clothes Washer Medical Gas ange Hood Water Heater 0 Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water ' 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 State Contractors Law 18.27 RCW and 296.200A WAC. iCity of Everett Official Use Only -105 PERMIT# pf �O I Owner/Authorized Agent Signature Date (Revised 9/23/2016)