2208 LAKE HEIGHTS DR 2020-07-14 - Laserfiche WebLink

4:77- PERMIT APPLICATIOI` BUILDIN.,, r MECHANICAL/ PLUMBING / SIGN i UI'RINKLER/ 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:2208 Lake Heights Dr„ Everett, WA 98208 PROPERTY TAX#:00463600000800 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: BETHANY OF THE NORTHWEST TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET POB 13700 CITY Mill Creek STATE WA ziP 98082 OWNER PHONE: 425-332-4486 OWNER EMAIL:kaia@bethanynw.org CONTRACTOR NAME: LL>6_k ts., �..\S f—y—Le CONTRACTOR ADDRESS: STREET Z Q( S' )_5:-;:--e--), 5 t- CITY / elG�©4,v[_5 STATE CL-' Ck ZIP cia YO 7 CONTRACTOR PHONE: 2S' 7 3 7 7- �S CONTRACTOR EMAIL: vi t-0../_5 c-i (SL, C>1.5'2-6 CONTRACTOR LICENSE#(REQUIRED):i —' (S L L.CS 5".r:5 8Z( CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): s.. 5 1 ( -1 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR OTHER(Please Specify) Owner Representative l O CONTACT NAME: CONTACT PHONE:425-231-4623 _ A.) Kai Anderson CONTACT EMAIL:kaia@bethanynw.org . BUILDING INFORMATION Existing Use of Building:vacant SFR Contract Price of Work: $ Proposed Use of Building:demo .Heat Source: ❑Gas DElectric I❑Otherwood stove BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ✓❑Demolition ❑Change of Use DESCRIPTION OF WORK: demolition of current structure/s and removal of all demo debris from site ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures 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 Ventilatior 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 1 Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 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 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. � , (y10/1072-018) 4 City of1 .., EveretterrOfficial Use Only "<� 1^ PERMI ( \ l l02 ©v Owner/Authorized Agent Signature Date (Revised 10/1072-018)