802 E MUKILTEO BLVD 2020-07-14 - Laserfiche WebLink

PERMIT APPLICATION; BUILDING-I MECHANICAL/ PLUMBING /SIGN if 'RINKLER I DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (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: 4i:30 Z ►yf N ytk:IA' o 'NlD') PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: j(1'Y (1 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREETS.9Z 0 0 da,r 51" cITY V STATE w-1 ZIP er Z0 , OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: W RFC404//1/ g, L-& 1,15.01.04-(7--/e,A CONTRACTOR ADDRESS: STREET j C4 e 3 r N td- AVE ] �j CITY Or !VV STATE to-p. ZIP-q. g C.O / CONTRACTOR PHONE: HZJ5 ' tel',Z " 5/0 / CONTRACTOR EMAIL: /Z' < fc-I QwreOl�i,3he l rd fmo.to*) CONTRACTOR LICENSE#(REQUIRED): 601- Q p 7$ -37 I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 03 '3 / Z 7 PRIMARY CONTACT: 0 OWNER 'CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: ^ CONTACT PHONE: ( Z`7 - 3 2-21 • 570 '1 5kICONTACT EMAIL: f e:/,(47 3 elp Gt>rec/6 f &7&/,cieoo, p BUILDING INFORMATION Existing Use of Building: tiete,a1L,yl ' Contract Price of Work:$ `gSe)-Z.2,1 D11) Proposed Use of Building: Heat Source: ❑Gas 0 Electric 0 Other BUILDING USE: ❑SFR ❑Townhouse 0 Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler CI Demolition ❑Change of Use DESCRIPTION OF WORK: ]� ;ryl�'L(T7 01 of '' 47 S th 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 Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only / ' Zi / y PERMIT# \q 0--Do I Owner/Authorized Agent Signature Date (Revised 4/15/2019)