5021 W HIGHLAND RD 2020-12-31 - Laserfiche WebLink

Mir PERMIT APPLICATION BUILDIN MECHANICAL / PLUMBING / SIGN M PRINKLER / DEMOLITION 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.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 50 Z 1 L.) l (6H L A m D t2orlAl PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: eiR/G 64 X0e 4- 'il,iy, k006i TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET/6°2. / Gt...) tl-}/&/.t -s i 0 9c ,3. E�c ,j CITY L.Ur��...K r ( STATE A ZIP 9g203 OWNER PHONE: ZO(p"S53-02(2 OWNER EMAIL: 4t2(6,8,1?oi2 I@ ,44 4t�,e0. CONTRACTOR NAME: e) 4.-2,i.2642- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: t5WNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 6 _-863-C)2/Z e1 L AA ?GE CONTACT EMAIL: 6,t L 134 e.( yq ty4,L_ 71,1 BUILDING INFORMATION Existing Use of Building: 'I- Contract Price of Wbr�pp�� : $ 2`�L';`'`" Proposed Use of Building �'j` Heat Source: ❑Gals// . lectric DOther BUILDING USE:. FR ❑T•wnhouse LiDuplex ❑ADU ❑Multi-Family-#Units: Commercial ❑Accessory Structure _ Type of Project: New ,12 Addition ❑Remodel ❑Repair T.I.❑ ❑Sign Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: A � AS !I'` pt 7 i& Ream vvl e-r 2 i o roApoce 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 1 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. 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. City of Everett Official Use Only PERMIT# ,i./., /0/8 /9 M.nC) , oq-9 Owner/Authorized Agent Sign re ate (Revised 10/10/2018)