8309 5TH AVE W 2021-02-25 - Laserfiche WebLink

• .„ kw PERMIT APPLICATION if ; BUILDING/MECHANICAL/ PLUM=ING /SIGN /SPRINKLER/DEMOLITION f�. .,<. �;.�� CITY OF EVERETT PERMIT SERVICES T: r >,irr 3200 CEDAR STREET,EVERETT,WA 98201 1�� ` r - kit Y)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits LGEiEGlie cm lSht&&Ink Onl , Please) PROJECT SITE IL iFORMATION IIFROJECT SITE ADDRESS:, -j (�.1 -r � . ��. PROPERTY TAX#:g O 4.i2.00 70O 4---ti.S.GAL for new construction: Short Plat/subdivision Lot No. / (attach copy of long legal description) " dZJ : CONTACT INFORMATION I. -- II- E.t . NAME: �¢Me/ u 4-- TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET / QS" /3o £r. Se. 0. A l /� coy C,' -/ / STATE //V ' ZIP /a92 li iOMER PHONE: 4-2 /'r 5V/- (O 9./ OWNER EMAIL: .r.iCONTRt,C T OR NAME: 57 e 7/ Gt 0 Y f/Y65vr 0g Dy t✓C rCON RA.0 a ORR ADDRESS: STREET (9"" /50 17 der: Se "4 4- i CITY ✓v (: 7-1-_ STATE 6.//4— ZIP?r to 4-2 11CONTRACTOR PHONE: LJ�f%-5)/ -6 �/ CONTRACTOR EMAIL: SD f�/1 5 0�T�'i/L r 00 Ai ICC (TRACTOR LICENSE#(REQUIRED):/ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRhi!IARY CONTACT: lid OWNER ®.CONTRACTOR ;XI OTHER(Please Specify) 0() of-r LxfO 0 h ir- CONTACT NAME: CONTACT PHONE: 2.c,b — 93s -2-?-/ 2 /f/-/t'I Y-c/G -c-7f- CONTACT EMAIL: if-C, (A C f�oi 7/ . co n _^ _� BUILDING PERMIT APPLICATION lExisting Use of Building: '—` Contract Price of Work:$ ii ,Proposed Use of Building: � 4- 7!v $ l t T 5 Heat Source: fl7 ❑GGas Electric DOth.er l]Building Type: DSFR-Detached ❑SFR-Attached ❑Duplex i Multi-Family-#of Units: 1 3 ❑Commercial ❑Industrial 4- 'Type of ProjectgNew DAddition ❑Remodel ❑Repair DT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use :DESCRIPT ON OF WORK: -li - ------614,s7 7v wA, & 5 c;- - J r; `.�,v a -t-2�W iJ 6 o 5 t 2/ &r7b 4 �L %0, , ASSOCIATED BUILDING PERMIT#(if applicable): _r;�:_!: G/M1ICAL PERMIT APPLICATION_ PLUMBING PERMIT APPLICATION lType of Project:K.New Addn _Alteration _Repair Type of Project: tC New _Addn Alteration _Repair of E List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures II Fixtures Fixtures Fixtures Vi INC-Air Handling Units Heat Pump - aj iToilet Backflow Preventer(Inside Bldg) I Forced Air Systems Unit Heater `, Bathtub Urinal I I Gas Piping Boiler 3 Lavatory(Wash Basin) Drinking Fountain II i Water Heater _ _Refrigeration _ Shower Floor Drain tl !Gas Fireplace - Wood Stove 'Kitchen Sink&Disposal Grease Trap I ;_Gas Range Ducting _ L (Dishwasher Roof Drains L_ 1 (Clothes Dryer Hookups Other: 4 Clothes Washer Medical Gas IL 1 ;Range Hood - - Water Heater Other: i. ±Exhaust Fan --- Sink(Service/Bar/Mop/etc.) Other: it- II- SPRINKLER 1_SUPPRESSION SYSTEM Number 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./am the owner,or!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#n I ' Owner/Authorized Agent Signature /Da e (Revised 9/23/2016) o 1