8307 5TH AVE W 2021-02-25 - Laserfiche WebLink

",,--- P I-R D APPUCATCO . f ��CQ.[�C�N MECHANICAL/ PLUMB MG /SCO9� C�C6�9C��[ R/ D h�4COL CTl CO�9 FCITY OF EVERETT PERMIT SERVICES rP`T'� 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 (Clue ow Mack Ink Gray PIeose) PNOJIECT SIT O=YMr T DOh^I PROJECT SITE ADDRESS: e 0-7 I I re e I l'i PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT IIN ORIIVIATIIOG1 OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CRY STATE ZIP . , 1,0 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): f j(- I-. / Pi "1 CITY OF EVERETT BUSINESS LICENSE#(REQUI ED): PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: .:t BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ - ' . Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: .,/ ASSOCIATED BUILDING PERMIT#(if applicable): (../ \ I J 0 I I GlJIIEC�'JAIYIIICA) PPI RRIIIIT APPLICATION - P[LUE BIND 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 #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater _ Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups j Other: Clothes Washer Medical Gas Range Hood I Water Heater I Other: Exhaust Fan I Sink(Service/Bar/Mop/etc.) Other: _I _ SPRINKLER/SUPP'ESSION SYSTEM (Chemical or Water E 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, ( - :L..�t� � �— Owner/Authorized Agent Signature Date (Revised 9/23/2616) ,, \I L