2131 LAKE HEIGHTS DR 2021-09-07 - Laserfiche WebLink

• PERMIT APPLICATION BUILDING/AIIECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)424.257-8810 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: o2131 LOlkd 1-Ie;911,+6-be. 5€ 5uArefl-WA PROPERTY TAX#: 2Aa 52.96320 500o LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT,INFORMATION OWNER NAME:P e`1I'tati U* J;lugI' La& TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 10 I pk 5 la r� 2 CITY K../o ere` ' STATE W A ZIP 4'820/0 u OWNER PHONE: 7 25- 38E- .2335 OWNER EMAIL: CONTRACTOR NAME: 51�, COw11 %er t!Lo.Q I+OtM1Srt-r11—CC-brL L.LC. CONTRACTOR ADDRESS: STREET 23144 q M14. A uQ. O • Sit 1 O 5 CITY Ken+ STATE W A ZIP 9803a.3 CONTRACTOR PHONE: c2C110^ Sao - 5o4,3 CONTRACTOR EMAIL: .3*QSOYL +C, 11K,Corp ttsA •COm CONTRACTOR LICENSE#(REQUIRED):'S KterytCC�Y$PA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 055t i PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 56q— Aso- 8 a-48 5d.Son Cil W-le. CONTACT EMAIL: Jason. C j vtcoriraSa,. [°am BUILDING INFORMATION Existing Use of Building: ' eye 4r. L a]ii14.6 Contract Price of Work:$ .3 5,esod Proposed Use of Building: Heat Source: OGas DElectric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: >4Cornmercial ❑Accessory Structure Type of Project: ❑New EAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: T hs-l-0-11c —T't pa. 14 T4 pe "1C 1 k . 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 I Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal I 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 i 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 C.• -ctors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only � /' /'j PEnR(MIT/ /'� �(� �—/ �Q� `� tl" V tL/ 1�Ja_ • ner/• or ed Agent Signature Date (Revised 10/10/2018) I/Z