8323 5TH AVE W 2021-02-26 - Laserfiche WebLink

• PERMIT APPLUCATl DOl' /IP' BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION f 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 �s ((BIRD ©P IBIack Ink Owll�y P sc) 3.I,�' PROJECT SITE INFO1''QIJIATION PROJECT SITE ADDRESS: . ' '? 5 Lb )tV-t (/.,J M 6-u,,l"iy i PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) r CONTACT INFORMATION OWNER NAME: Lci,S i/vj q TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: 9,06 —`6:3C} — 0)2-6 OWNER EMAIL: CONTRACTOR NAME: A (3G.1 yr s 3,c pro j-ecd- b �- CONTRACTOR ADDRESS: STREET 7 09 t, /410u47`q9 rt 1/t i',,. +,-5 tit_tit_Cm' 0/ei; if iry STATE I,, . . ZIP (A'. C? CONTRACTOR PHONE: z' I CONTRACTOR EMAIL: A re, mot'it. ez- ',if.) 7di' i e CONTRACTOR LICENSE#(REQUIRED): A f I20W FP-6 ul1 ?k. CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):*-l('G 2 ' 4. PRIMARY CONTACT: 14 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: t� CONTACT PHONE: y2j- 30 - 8•1 IY1 `�tfi.SOltl ,J II). CONTACT EMAIL: of f fu,.,?.act (6 6- i Jw-t4`I , ( 0- 1311,0ILDING INFORMATION Existing Use of Building: Contract Price of Work:$ -i6" U L -)U. r Proposed Use of Building: %vfr1^io o.:,es Heat Source: ❑Gas ,Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: 4New ❑Addition ❑Remodel ❑Repair CIT.'. ❑Sign• ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: xn5A.,/,/ syroffg;a... ;-„,. �.e5,' ncz ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PE?MIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units 1 Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo ' Boiler Gas Range Clothes Washer j 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 Ventilatio 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 i Water Heater I__ SPRINKLER I SUPPRESSION SYSTEMSewage Ejector or Sump Pump Other: Water Suppression System No.of Heads 1 Chemical Suppression System i I 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.lam the owner,or tam 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 R PERM,ITA 4 O;r 009 , c ;-47 C---- )..--- Owner/Authorized . en1Signature Date (Revised 10/10/2018)