1509 CALIFORNIA ST DAWSON PLACE 2021-07-12

IM • PERMIT APPLICATIa 112 BUILDING / MECHANICAL/ PLUMBING / SIG / 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: 1.3,, 7 (AL mac A);A A e.. PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: (MCA)1 Jv/ Q/4 re TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET (5 o', <'iq Li'For,o,fA )4 1,1- / �� cm, ��'' E V 1 :- ''7 7 STATE ZIP OWNER PHONE: 11 OWNER EMAIL: CONTRACTOR NAME: c f(,,1--6 jN"ftJe--;>4 CONTRACTOR ADDRESS: STREET I "7 /( Poo- 9(-- CITY 1./CA.,if(:WI(744 STATE ( 14 ZIP 2 7S 2 3 3 CONTRACTOR PHONE: 3cz' ,-7-5-'�,--‘,742 CONTRACTOR EMAIL: V f2);'p 4.499.6iljt... `,, , C,,,s-c CONTRACTOR LICENSE#(REQUIRED): 2 t.1,Ate-445 J L, .. CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): V�6(0�7 PRIMARY CONTACT: 0 OWNER FCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: i�j) 7 5 ?- 6 5' �) 1 11 i L �- Uc(! _ CONTACT EMAIL: IG.t�L A a i. z-k , z-�� ''� BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ I 1/909-,r ':. . Proposed Use of Building: Heat Source: ❑Gas 0 Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ODuplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ODemolition ❑Change of Use DESCRIPTION OF WORK: r) ., /146 tiles ?s. Y I./'¢t 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/InserULog 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. 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. 7 City of Everett Official Use Only PERK 1 i ` �� z jZature (Revised 4/15/2019)