3105 BROADWAY 2021-02-22 - Laserfiche WebLink

Mil PERMIT APPLICATIOa BM BUILDING , ECHANICAL / PLUMBING / SIGN oPRINKLER I DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (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:3/CTpyrz tkey,/,EI 2Yer- 1L) 9,9: ` PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision 17 /4 Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: . i ete (/v'=>G/c HOfVfr TENANT BUSINESS NAME(Commercial):(5rccjiAA:`/S �,X(,,,G 'fZ OWNER MAILING ADDRESS: STREET /Q �.�rnd u'/ // CITY FZJ p t / STATEA a� J g ZIP 9&20/ OWNER PHONE: .3((-) -- 3)/ — OS I g OWNER EMAIL: 7 ew(1//©nl, ‘/ A) rn s a"` /'coin CONTRACTOR NAME: 4(01)9 ' -- jcr,v'�►S /L v�aC�J. CONTRACTOR ADDRESS: `STREET 76 ;n9 46/f 1 q'� `j 7� CITY / �� ll}�7/ Cr STATE j�J�}" ZIP -,k--0,1-0 CONTRACTOR PHONE: . pi(/ i/S CONTRACTOR EMAIL: ,)1.44 �je/ui,p'2r , �...S- ,4i/ C_ 1 CONTRACTOR LICENSE#(REQUIRED): (` C w)(O NC7 �`scP*, N1 CITY OF EVERETT BUSINESS LICENE .#(REQUIRED): 5 v4O PRIMARY CONTACT: r i OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 3 bt 7 19 •— ac3 CONTACT EMAIL: BUILDING INFORMATION :,f Existing Use of Building: may[ ��tom r1 70 4 Contract Price of Work:$ Proposed Use of Building: '` . t •J ` 1te040 - Heat Source: ❑Ga '-. ,__'_Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse El Duplex ❑ADU ❑Multi-Family-#Units: '®Commercial Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler iit Demolition ❑Change of Use DESCRIPTION OF WORK: "Imutt_ -ED me Ve -5pri`n k 1 e rs s m 13ecaKse, •tti e-. current_ coop ` �S Y1t l, cj U i Y� i t . 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 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only / PERMI V#� ^ 3 '1'C`i�� r PwY 1 Owner/Authorized Agent Signature — Date (Revised 4/15/2019) )