9434 HOLLY DR 2021-08-26 - Laserfiche WebLink

PERMIT APPLICATIO ILL 101 BUILDINGGECHANICAL/PLUMBING /SIGNIRINKLER/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: 9(/2Y Flo i/y 1)(, EGA'/ 14- (,vA. 992cy PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: mR, & {gigs bifi gs ri TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 143VV� holly 1)R CITY EI,e e l(} 1 STATE A ZIP q f oc1 OWNER PHONE: ti LT 35' 3-GWil OWNER EMAIL: CONTRACTOR NAME: kj {Jes+ scot-4- CONTRACTOR ADDRESS:"_ STREET 19 Lj Z/ $2 hi Aye w,CITY rl J VOI/00Je STATE IVA ZIP 01436 CONTRACTOR PHONE: LI 25 "l 3L- lipp - CONTRACTOR EMAIL: A.5.0 f4- @ ii%1 fl k S I j e,14ctc F £-OM7 CONTRACTOR LICENSE#(REQUIRED): S I L LEGS.g0Yf t/ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): '' PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR IVOTHER(Please Specify) WO/'k e/' - "ii4-c he%/ Sefi4-- � j CONTACT NAME: CONTACT PHONE: � hq lkhCtr/ S404 CONTACT EMAIL: yylse f it rt?k S,)f e/rhgaC i` .Cali? BUILDING INFORMATION /' ` 7; Existing Use of Building: Contract Price of Work:$ (1, ir , 0 CQ 2c C� Proposed Use of Building: Heat Source: 'Noes ❑ ctric ❑Other ) BUILDING USE: IiSFR ❑Townhouse ElDuplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel .Repair ❑T.I. ❑Sign ❑Sprinkler tgrDemolition ❑Change of Use DESCRIPTION OF WORK: Rebvtidin3 (7)(97.3 Je, k SCG,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 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 Ventilation 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/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.I am the owner,or l 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 14/7/, i 1 '.09-1°11) P Z-1-10 ,\ r OS LO Owner/Authorized gent Signature Date (Revised 10/10/2018) l /�