840 N BROADWAY B 2020-08-27 - Laserfiche WebLink

PERMIT APPL_ICATIC BUILDING.: I MECHANICAL I PLUMBING 0 SIGftI .SPRINKLER I DEMOLITION OLITION CITY OF EVERETT PERMIT SERVICES EVERETT 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 s� (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: o7O3/2GI9LG r'7 a" �(f Yz-hi/% PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: la pr fj'< E57'G(,tj ,t/c N 12/_ TENANT BUSINESS NAME(Commercial): I%-C25-/ OWNER MAILING ADDRESS: STREET ZS;5 G✓, �ryrr b/ei 4T CITY /1/4-24),,-04,/ STATEE11 4 ZIP Yb' /,n 37 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:/-1475,12 C/41.6vP6.6NGy iPj67L1/jLt;S' "v0 / Si Orr.//i/vii/ CONTRACTOR ADDRESS: STREET /QpC7 4 341.37- .rj-11 CITY is/Uivi,/ STATE iy,/,/ ZIP 9SZ357 CONTRACTOR PHONE: 4%z-ssLSC -(i,$'oo I,' CONTRACTOR EMAIL:(;0/, /L,. c/pr/ ,zi /zp, c -t CONTRACTOR LICENSE#(REQUIRED):;4 46 i?Wi Z5 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):CVO/ PRIMARY CONTACT: 0 OWNER El CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: �-� , .5-01; i 0S/ / �it/e-C/I/, CONTACT EMAIL: 6c4wJE%).r C/ILC�I f1� 7>Yir/i3 1� ?lJ/on BUILDING INFORMATION Existing Use of Building:rt;,;,, T-/v irdc-<715/4/up/uit►h Contract Price of Work:. lam CA9z00 Proposed Use of Building: Heat Source: ❑Gas KJElectric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: QCommercial DAccessory Structure Type of Project: DNew DAddition DRemodel DRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK:.J1opsmik: /Z(J/✓�/�� ftv3ixix7 4.20,4„16,47._ cm/ .b.---ns.Wr2y-5.7-��o(�� -/ vu-✓�.c �c;�l..� cam'- cx/v runs 6p • /711,341,-..1 yfe �I isfeer pt-Ntazt ll 675_ rizot e 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 I 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.1 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. T(\ City of Everett Official Use Only 9///// ? P E �i ] � 68 Owner/Authorized-Agent Signature Date (Revised 4/15/2019)