8311 5TH AVE W 2021-02-25 - Laserfiche WebLink

PERMIT APPLICATVCO BUILDI I MECHANICAL/ PLUMBING / SIGN I SPRINKLER I DEI+'fIOLITI�IiN � I 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 ((Maze or Mack Ink©My Please) PrzOJECT SITE MF0RG1!'dATD0N _ PROJECT SITE ADDRESS: 631 I I !'< 1'1 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) i CCOIRITACC TI' OMFOR%RAT11 OOL1 OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: . CONTRACTOR NAME: /-i j j::4 CONTRACTOR ADDRESS: STREET ,Hi..,. i CRY I_ J/ '.l j,/:,. STATE (.b Pf'% ZIP <..j v��:-(4.- CONTRACTOR PHONE: CONTRACTOR EMAIL: .x bONTRACTOR LICENSE#(REQUIRED): k 0---:L. !-t.' /` I`' Yj I % CITY OF EVERETT BUSINESS LICENSE#(REQ IRED):T1 I len) PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: _( .6 A / _. CONTACT EMAIL: .1 f r It U1 jLDIili]O IPE J MMT APPLOCCATOOI I 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. ESign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ASSOCIATED BUILDING PERMIT#(if applicable): 0 C I U 1. V� EC ilAMICAL P1r�MITi APPLIICATIIOli31 PILUV�f EdM6 PE!'MIT APP[LIICATIMAI _._ 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 NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub I Urinal Gas Piping Boiler Lavatory(Wash Basin) _Drinking Fountain Water Heater Refrigeration Shower I Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range 1 Ducting Dishwasher J Roof Drains Clothes Dryer Hookups II Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: 1 SPIRIINKLL[EC8 GSUPPF'ESSIOGkt SYSTEM _______ Chemical or Water 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# .\ \ 1 OM Owner/Authorized Agent Signature Date (Revised 9/23/2016)