7124 OLYMPIC DR 2021-06-10 - Laserfiche WebLink

i . , 1 PE•MIT APPLICATIOdk >UILDIN VMECHANICAL / PLURII I JG /SIGNIMPRINKLER DEMOLITION CITY OF EVERETT PERMIT SERVICES EvE g 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 (t-lane a r Black Ink Only Please) PROJECT E1TS9NVrET AM®iR9 PROJECT SITE ADDRESS: -7 I al( O (din if PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision^ Lot No. (attach copy of long legal description) CONTACT I FOR 9% OWNER NAME: i ct.r-b(.l--c1/4._._ Cc c 2 4I TENANT BUSINESS NAME(Commercial): 0 OWNER MAILING ADDRESS: STREET 71 oZ- Q I f�rv1 lac_ Dr CITY y l/G♦•C ✓J ` f STATE 0 ZIP 10,03 OWNER PHONE: .2_069 of 02J S- OWNER EMAIL may OC_S551 0 s YA1Q1 I CONTRACTOR NAME: _ f (J,c ry,y/'> CONTRACTOR ADDRESS: S REET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: OWNER ❑_CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: 6 3tx.("G,_ C6tiw\1D 1°€'I I CONTACT PHONE: 206) 7i2,(,1 CONTACT EMAIL: 3c ct vi es �2y a '. C e� BUILDING.INFORMATION Existing Use of Building: S F Contract Price of Work: ZT6 Proposed Use of Building: S F 10 Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: I2 FR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use .(, DESCRIPTION OF WORK: wm uoP�ri.jf {� _eine --...� ail ahlin 1s• h'ecQ Ipcsse .nen l Cap ® uda:fe t o sin LGLs Cap v 1,voo� -;s-� '!� ' rv,st.. ehrm2n . Ne_vyyove GIyu'a I -"o tetiecc, ,,ttnYin . 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 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) 1 Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas yWater 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 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 lam 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 ,t PERMIT# G/ //'/�-7 r 02-.2&".2Oc O t.1 _ _, - -/ Owner/Authorized Agent Signature Date (Revised 4/15/2019)