4831 DELAWARE AVE 2021-05-04 - Laserfiche WebLink

• PERMIT APPLICATION• BUILDING / MECHANICAL / PLUMBING / SIGN /SPRINKLER / 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: / k. ) J ? /l 716 itietr0e PROPERTY TAX#:(' I0.;{ 000 i//('Q LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: jj l� 6 .f f C- TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET ( U alC.7 5 6 fba t1.)a. c. CITY EV e net— STATE �e zip gCr OWNER PHONE: 17fr 5 -3 57 - 76 2./ OWNER EMAIL: I ; ., �`��•"$ e1 C Oo 1,4,c ft d rt . c e4''f CONTRACTOR NAME: ) ,—1 .(t `J CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: KoWNER ❑ CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: /r .� 33 / 7�>�� t r i i im ( h'7)evt CONTACT EMAIL: ;!'„V ( C i. <' nr>j1 S rGt C l b t� C�� 1 BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $ 2 fj^ OM. c�� t Proposed Use of Building: G c d-c.1 c<-u Heat Source: ❑Gas ❑Electric ❑Other A)/4 BUILDING USE: DSFR ❑Townhouse•)❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial , (Accessory Structure C 6,ri2rN Type of Project: 'KNew ❑Addition ❑Remodel ❑Repair T.I.❑ ❑Sign ❑Sprinkler ❑Derr olition ❑Change of Use `� DESCRIPTION OF WORK: 4 }— Car- „s ,may‹e c2+� ex,5)'• n 14• C. e45/GG1c de �1 aint'le Alft� u ff(1:9 , mc�-e/ l 7 '� .�—�� k,,e 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 A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer _ 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 Ventilatior 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 Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 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.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 Imply with the State Contractors Law 18.27 RCW and 296.200A WAC. /City of Everett Official Use Only \ ' �- __._ 7 --,:?,1 - 202() PER 2_ D (L1 Owner/Authoi Zed Agent t�� Date g Sig `!"'F (Revised 10/10/2018) I ") 6 \ .� 1!