6323 BEVERLY BLVD 2021-07-12 - Laserfiche WebLink

OLT • PERMIT APPLICATIO• BUILDING / MECHANICAL/ PLUMBING /SIGN/SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (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: (,SZ3 f'xu .l y 6it/D PROPERTY TAX#:OO5;Ia O0000zoo LEGAL for new construction: Short Plat/subdivision 000 p-00 Lot No. 2 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: NiGI vetcj er TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 63 Z.5 ( ev/cri y I! I iIT CITY EVe6o't STATE VA ZIP aD�.. OWNER PHONE: C200 355' 510 a OWNER EMAIL: na 1,4,Icl, .Co-, CONTRACTOR NAME: 6 , NE R CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: N OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:CO, 3 -6-10a `-�GNjp1 WeIGhP�y- CONTACT EMAIL: DaLJ IGAe @ &Ma>l.con BUILDING PERMIT APPLICATION Existing Use of Building: 5:Mak F4/4//y Rrs,1e .c Contract Price of Work:$ Y O I S \t Proposed Use of Building:Sy, 4evol I1 ReS,Avc.L Heat Source: %Gas ❑Electric ❑Other Building Type: ❑SFR-Detached OSFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition %Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: a'icehe'ed Coin rev 4G (1tf itA . .#GC-t ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn ,Alteration Repair Type of Project: _New XAddn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures NC-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) a. Forced Air Systems Unit Heater 1, Bathtub Urinal Gas Piping Boiler 1 Lavatory(Wash Basin) Drinking Fountain j Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range (e Ducting Dishwasher Roof Drains 1 Clothes Dryer Hookups Other: 1 Clothes Washer Medical Gas Range Hood a Other: a Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water 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 PERMIT#c°‘, o 2 + (MO ner/Authorized Agent Signature Date (Revised 9/23/2016) l '/y