Laserfiche WebLink
0 <br />0 <br />PERMIT APPLICATION <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />OL <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov i www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 4123 Hoyt Ave <br />PROPERTY TAX #: 00582101601100 <br />LEGAL for new construction: Short Plat/subdivision so. park add to BLK 016 -00 Lot No.11 & 12 (attach copy of long legal description) <br />CONTACT INFORMATI,O P 1 '"cam <br />OWNER NAME: Murphy Management Sevlces Corp TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: STREET 7110 48th Ave W <br />c,n Mukilteo STATE WA zip 98275 <br />OWNER PHONE: 206-719-3900, Kevin Wilson <br />OWNER EMAIL: Kevin@imfishin.com <br />CONTRACTOR NAME: T,i <br />CONTRACTOR ADDRESS: STREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR 0 OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: 425-876-4447 <br />ESG Design, Elaine Groth CONTACT EMAIL: esg4design@gmail.com <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: 5 r e- <br />Contract Price of Work: $ h6i2 4- <br />Proposed Use of Building: Duplex <br />Heat Source: []Gas OElectric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached C]Duplex ❑Multi -Family-# of Units: 4 ❑Commercial ❑Industrial <br />Type of Project 'New ❑Addition ❑Remodel []Repair ❑T.I. ❑Sign []Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />Q , d OPJA96 <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _ Addn _Alteration Repair <br />Type of Project: _New _Addn _Alteration _Repair <br /># of <br />Fixtures <br />List of Fixtures <br />Fixtures <br />List of Fixtures <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C —Air Handling Units <br />Heat Pump <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />Forced Air Systems <br />Unit Heater <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler <br />4- "L' <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />4 <br />Water Heater <br />Refrigeration <br />Shower <br />Floor Drain <br />Gas Fireplace <br />Wood Stove <br />4- <br />Kitchen Sink & Disposal <br />Grease Trap <br />Gas Range <br />Ducting <br />A' L" <br />Dishwasher <br />Roof Drains <br />Clothes Dryer Hookups <br />Other: <br />Clothes Washer <br />Medical Gas <br />4� 1p <br />Range Hood <br />Water Heater <br />Other: <br />1-2' <br />Exhaust Fan <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />Tub/Shwr cornbo <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />_ <br />Number of Heads <br />ACKNOWLEDGEMENT: Ihave reviewed this application and confir ion contained herein is true and correct. Work done pursuant to tn;s permit musr comply wire <br />current federal, state, and local law. The granting of a only authorizes proved work and no deviations therefrom. Deviations must first be authorizers in writing from the <br />Building Official before thorized under a rc nstance. I am owner, or I am authorized by t ;e owner of this property to perform the work for which application is made, <br />and I comply wi a State Con actors La .27 CW and 296. A WAC. <br />CityofEverett Official Use Only <br />PEFjM1T� <br />Owner/ Auth zed Agent Signature Date (Revised 912312016) v <br />�I7 :- <br />