3016 NASSAU ST 2021-06-10 - Laserfiche WebLink

• III NMI PERMIT APPLICATION 11 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 Ploaso) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: ";(7.'‘ ("-' - c,y, S{ .t.'`:.(L{t k 1 4 k PROPERTY TAX#: CC`41.5 1�"7 •z_3G'Z-44 " LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: N ..-,n .(A,c0c3 rr,5; TENANT BUSINESSSI! NAME(Commercial): OWNER MAILING ADDRESS: STREET ?)C.?)C. )4' I�e7 fi In C'1 'gip �?(� `.i "ff STATE 76 ZIP cT('`j �Dt CITY � 7Cer':- OWNER PHONE: OWNER EMAIL:A J �. CONTRACTOR NAME: ",E-v.�\.. _, Y�'E-C e ;\.e_Ci t ' g/ -i--{ :-%16, CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: p CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): 67.'<e--ry\•. l E.1 \& CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): L/ 7 Vy y PRIMARY CONTACT: ❑OWNER XONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Ze :-7•q.,- 499-fii C.. A.,i c',-Y V)He\ CONTACT EMAIL: J per / C wet BUILDING INFORMATION Existing Use of Building: t, cN.,)) - tv,,' I -I Contract Price of Work:$ I'5, t5Cl2 C-7 Proposed Use of Building: S : c� c, ,. ._ �-..•:c\a ^'11 Heat Source: ,IRGas ❑Electric ❑Other BUILDING USE:JEI6FR ❑Townhouse ❑Duplex 177ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: CNew ❑Addition ❑Remod I Vepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: v�r�� I P�. \ C 1� S v eta ti 4<' ek ' 4ll.�S F' �e- l v)rn ►r`7 'G•ryP =- cos-r. 1 1�rO ) 1 4.,c\J c Cry, L 4 r,(('I�`'Gc:7. _. 1, S,' N.)o,\ri s 1 .'_ c-Ser, r� .�- k-�' Lttv.s� fi� ( " r ASSOCIATED BUILDING PERMIT#(if applicable): OW lel,0$-•DC& 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) I Shower,Tub,or Combo Boiler Gas Range IJ Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless I Dishwasher I Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain I Toilet Exhaust Hood(Type I) (Not Heat/AC system) t Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil 1 Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains I Water Heater SPRINKLER!SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other. Water Suppression System No.of Heads Chemical Suppression System -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 IT _ _( 5 --- _ •z- /1C/ C' e_:..- PE�nu#I n }v)02-- c�J Owner/AuthorizecAgenfSignature Date (Revised/ 10//11 /0/2018)