8301 5TH AVE W 2022-02-28 - Laserfiche WebLink

PEh�tlP98IT AI PLDC"i O 1F UILDIPI"1 MECHANICAL I PLUM tING I SIGN / PRINKLER I DEMOLITI�•Nl rA 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 (I laaue or slack Ink Only Please) Pr OJI�CT SITE INF�-h'MATION PROJECT SITE ADDRESS: r 4 L V PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFO IrMATI t 1`' OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY .. STATE ZIP OWNER PHONE: OWNER EMAIL: . CONTRACTOR NAME: jl!?R D ar- ,:r Pf Y e 6, r% CONTRACTOR ADDRESS: STREET r C7- a •0 1-(4 is V k/ tiq Ivy'_ CITY / Jt`'0,5/3+,../rq, STATE WA!y' ZIP 9 V t to CONTRACTOR PHONE: CONTRACTOR EMAIL: A bONTRACTOR LICENSE#(REQUIRED): /7 0 I ") 4/7 ) CITY OF EVERETT BUSINESS LICENSE#(REQUI ED): 44 PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR 0 OTHER(Please Specify) 1 V441 I CONTACT NAME: CONTACT PHONE: q2 5-3c,1 <1 i.'1 -3 -4,1 C) C b-% CONTACT EMAIL: A 11-&r-,) (I/1, ;a e /1el P 1, U.'i;, , BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ t/,, . Z�' Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: DSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: ❑New DAddition DRemodel ❑Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: '` )( f 2, r .�-f%5'��.?, r`;,4�- 5'i.'p+I�It�a.:�j� rr� t�•CJ A`-C6 , �`{�ri e&`� Ff i� ASSOCIATED BUILDING PERMIT#(if applicable): O11,01,_ 0$a MECHANICAL PERMIT APPLICATION PLUM ING PERMIT APPLICATION Type of Project: _New Addn Alteration _Repair Type of Project: _New _Addn Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump:' Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Neater Bathtub Urinal -- Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor-Dfain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINICLER;TrU,PReSSI®N SYSTEM Chemical of Water) I 1 . 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 Bu`ifd1i g 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# 1 \...... 004 r V Owner/Authorized Agent Signature '`'' Date (Revised 9/23/2016)