5118 23RD AVE W 2020-08-28 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/ PLUMBING/SIGN /SPRINKLER/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 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:5118 23RD AVE W PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: BARBARA KELLY TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: sTREET5118 23RD AVE W carr EVERETT STATE WA zip 98203 OWNER PHONE:425.405.3071 OWNER EMAIL: CONTRACTOR NAME:EYLANDER SALES &SERVICE CONTRACTOR ADDRESS: STREET3601 EVERETT AVE CITY EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425.259.2161 CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED):EYLANSSO42K2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 016363 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425.231.2275 CORNELIUS TOO CONTACT EMAIL: Tcej Iapldt�rc��T' �ahoo 60/►') BUILDING INFORMATION JI Existing Use of Building:SAL„,-- Contract Price of Work:$8000 Proposed Use of Building:SFR Heat Source: ❑Gas DElectric ❑Other BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ✓❑Remodel ❑Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: HEAT PUMP&AIR HANDLER-- lrp �,��y,�,- U/1A taff ovrp/ue- ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT peri I A i ri Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures 1 NC—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 Ventilation 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.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply it the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 7/IPERMI(Q 7-'O7 O - uthorized Agent Signature /77 (Revised 10/10/2018)