624 93RD ST SW 2020-06-19 - Laserfiche WebLink

PERMIT APPLICATION �/ BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER!DEMOLITION 1.1%'!"?---A _ 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.govfpermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:AZ`1 q 3' 5/ 5btf / 18'2.0 y PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:4-Q k-t_ V./ea)a/ 1 L.G e. TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET .301 5 7 A c rs w CITY 0/P,i P✓Cs, STATE 1"6".4^ ZIP ? '5 /L OWNER PHONE:._6 © -- TKO -D.f 75 OWNER EMAIL& — e cri. 8 pP c p/.pC.v Le /Pi 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 ❑CONTRACTOR s,E 'OTHER(Please Specify) 7 rL rd..-;7" CONTACT NAME: CONTACT PHONE: K 75� 3�2 % `I..- .- 6tiekt,iS'e rl Mann c, CONTACT EMAIL: L k'lIfY�1 l 01 _`'-1cAi(�,Yt o0 " BUILDING PERMIT APPLICATION CXJrki'_ Existing Use of Building: Contract Price of Work:$____ ------ Proposed Use of Building: Heat Source: ❑Gas 0 Electric 0 Other Building Type: FR-Detached ❑SFR-Attached ['Duplex ❑Multi-Family-#of Units: ['Commercial ❑Industrial Type of Project ONew ❑Addition CI Remodel ['Repair ❑T.I. ['Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: / ella c r-p U r7"--> 1 � ! Ro0i1ehdnO ca/`j7or7- "-- C 10 s ie 7-', pi_ c/it per- ,Tva s .Ta I'5e. 6-c h,&c' i:2, 00/1- . ,c1,.‘ FQC ASSOCIATED BUILDING PERMIT*(if applicable): 1r-NR-o11(^t`r © rLc,(5oect '-o i '^S j-C-4 O r- ) MECHANICAL PERMIT APPLICATION i PLUMBING PERMIT APPLICATION Type of Project ___New ___ Addn __Alteration ___Repair Type of Project: __New __Addn ___Alteration ___Repair if of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC-Air Handling Units Heat Pump Toilet Backflow Pr er(Inside Bldg) Forced Air Systems Unit Heater Bathtub Uri Gas Piping Boiler — Lavatory(Wash Basin) rinking Fountain Water Heater **iteration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Dis Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer H Other. Clothes W er Medical Gas Range Hood Wate eater Other: Exhau n , (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.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 .if cumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and 1 c. ply with the State Contractors Law 1 i T and 296.200A WAC. City of Everett Official Use Only 7 Ow ;frorized Agent Signature Date (Revised 9/23/2016) (7--)