4421 RIVERFRONT BLVD 2021-09-08 - Laserfiche WebLink

PERMIT APPLICATION LI BUILDIN(OECHANICAL/ PLUMBING I SIGN•RINKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICEb 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: ;. .:.Il g lui fzip1T soli), PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) . CONTACT INFORMATION OWNER NAME: 4. (rot)illAv TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 44.14 j, i;?,i v ? t)t T f u p CITY EvEF:at t STATE W ZIP 45 'OWNER PHONE 4? 23 2-, -2.h0 OWNER EMAIL: R�p Vt 1p .7 t{ 4 P4 CONTRACTOR NAME: NIA- CONTRACTOR ADDRESS: STREETlI CITY STATE r ZIP CONTRACTOR PHONE: -PI Dr- CONTRACTOR EMAIL: $3 / A- CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: XOWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: q, 6- 023 2-.. -- o P GOOD • CONTACT EMAIL: F,S; y eZ_VL5(,t in k . BUILDING INFORMATION Existing Use of Building: lfl��VAttlii„L, Fg. t DrAT Contract Price of Work:$R Arc ;Z7.:45/i Proposed Use of Building: ag- Heat Source: DGas DEI ctric ❑Other BUILDING USE: J$SFR ❑Townhouse ©Duplex DADU ❑Multi-Family-#Units: DCommerciai DAccessory Structure Type of Project: CI New MAddition DRemodel ❑Repair ❑T.I. ❑Sign DSprinkler El Demolition ❑Change of Use DESCRIPTION OF WORK: IUD at.) 4'cX (4' wralizcOliA cad P* et.' l 1 1/16 3° IPS TWO e..14-R c , V-, 3 2 )< (2 t =- ' S42 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERM T 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/Insert/Log Roof Drains Water Heater SPRINKLER I S UPPRESSION SYSTEM: Sewage Ejector or Sump Pump Other Water Suppression System I 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.1 am the owner,or 1 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 298.200A WAG 1 City of Everett Official Use Only P1110 r 0.--4 t 10/9 PER ft LC(()° _ Cal< Owner/Authorized Agen ignature Dte (Revised 4/15/2019) i