Laserfiche WebLink
• PERMIT APPLICATION I* <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 1920 100TH ST. SE BLDG. A <br />PROPERTY TAX#: 28052000202100 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: SEA MAR TENANT NAME (If Commercial): SAME <br />OWNER MAILING ADDRESS: STREET N/A <br />CITY STATE ZIP <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: UNIVERSAL REFRIGERATION <br />CONTRACTOR ADDRESS: STREET 4102 B PL . NW. <br />CITY AUBURN STATE WA "P 98001 <br />CONTRACTOR PHONE: (253) 939-5501 <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): UNIVERI159RF <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 027645 <br />PRIMARY CONTACT: ❑ OWNER El CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />AIDAN WILSON <br />CONTACT PHONE: (253) 939-5501 <br />CONTACT EMAIL: DESIGN DESIGN@UNIVERSALREFRIG.COM <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: OFFICE <br />Contract Price of Work: $ 12,000.00 <br />Proposed Use of Building: <br />I Heat Source: ®Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi -Family-# of Units: ®Commercial ❑Industrial <br />Type of Project: EINew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition []Change of Use <br />DESCRIPTION OF WORK: REMOVE & REPLACE OFFICE DIFFUSERS WITH NEW. <br />ASSOCIATED BUILDING PERMIT # if applicable): <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: X New Addn _Alteration _Repair <br />Type of Project: _New _Addn _Alteration _Repair <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C —Air Handling Units <br />Heat Pump <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />Forced Air Systems <br />Unit Heater <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />Water Heater <br />Refrigeration <br />Shower <br />Floor Drain <br />Gas Fireplace <br />Wood Stove <br />Kitchen Sink & Disposal <br />Grease Trap <br />Gas Range <br />Ducting <br />Dishwasher <br />Roof Drains <br />Clothes Dryer Hookups <br />Other: <br />Clothes Washer <br />Medical Gas <br />Range Hood <br />19 <br />DIFFUSERS <br />Water Heater <br />Other: <br />Exhaust Fan <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />SPRINKLER <br />/ SUPPRESSION <br />SYSTEM <br />Chemical or Water <br />I <br />I No. of Heads <br />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 <br />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 <br />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, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Digitally signed by Aldan Wilson <br />cn Wilson, o, Aidan Wilsonemail=Arwilson@Live.corn, <br />c=US <br />Date: 2019.07.12 09:25:06-07'00' 1/ 2 7/ 2 0 <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />PERMIT <br />b <br />(Revised 912312016) _ <br />