4106 OLIVE ST 2021-04-01 - Laserfiche WebLink

® PERMIT APPLICATION IL BUILDING . ECHANICAL/ PLUMBING I SIGN / . RINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 4/D4' O h k_ s 9g2,9 3 PROPERTY TAX#: 1905;4 2,OO S PO V-100 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) p CONTACT INFORMATION OWNER NAME: /6 / L-`' TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET Po g©y /J Zif ''`�Q a pp /� CI�TYY 6✓GrGti- / STATE �"' r r ppp ZIP IQ 2-04 OWNER PHONE: 119 V l t o 7 v 1 If OWNER EMAIL: IQ Vide le/ �GS 0 1;1 �d e eCj mg 1 /t e0'" CONTRACTOR NAME: TOD c� CONTRACTOR ADDRESS: STREET CITY STATE ZIP - CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: gOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: i-oc, q L1 b if Ct 7 Pa VI Of r1 L o�GSC9 illCONTACT EMAIL: C(µV I4 C✓► 5 SSS'i@L9 ha a I /, tetirf BUILDING INFORMATION _gym'- SS Existing Use of Building: A.C5 t Lfrflh4 I s-rt Contract Price of Work: p_00],�, 5 5 Proposed Use of Building: fAtstdrt-f-'i / SE�2 Heat Source: Gas ❑Electric LtJOther BUILDING USE: ItSFR ❑Townhouse ❑Duplex OADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New 1 4ddition Remodel ❑Repair DT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: .ro,ockI d'1'laih4% dory 4-d�d dlfI Dti �be ✓e . 2 5 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT 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 Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer (I Sink-Commercial(3 comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) • eration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) ommercial 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 System, Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Ipsert/Log 'oof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM l Sewage Ejector or Sump Pump Other: Water Suppression,:ystem No.of Heads Chemical Suppr-.:. . . • 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 /41/17( ‘11Ai(---------- PERST k 3 ^0L Owner/Authorized Agent Signature Date (Revised 4/15/2019) 1 �J