2902 COLBY AVE 2021-11-02 - Laserfiche WebLink

MIN • PERMIT APPLICATION. BUILDING / MECHANICAL / PLUMBING / SIGN /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 I ' I • �.r�" PROJECT SITE ADDRESS: orZ! t .ii711 PROPERTY TAX#: 2O 4' ?/6, .e'3 3 O LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: � 9 ),°;, (?i)1.-3 T , TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET p' 2 00 �4, 7 cnY V "' ,C f 1' - STATE ijdA, ZIP 9Th 6� OWNER PHONE: /j/ d? a "Y,* ! OWNER EMAIL: /4"R7-- ''' 5 X.0 r'4�".-, t.„ CONTRACTOR NAME: 6Am /.1- ,'J CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: %OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 6/X9". k ... A AT f? 6 g,,Y O7- A '°'" CONTACT EMAIL: 1=.I)III 1?d1 f' 1I II d,'11 Lll(� i(' Existing Use of Building: C% 7' Contract Price of Work: $ /Ca "rS'„ c ' ' ' /),Dde ARA173,E, Proposed Use of Building: CO%7-J- Z l't S Heat Source: ❑Gas DElectric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex EADU ❑Multi-Family-#Units: Commercial ElAccessory Structure Type of Project: :New EAddition ❑Remodel ❑Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: A d New A 4. > FROni ,Y-, ,4?;-tei : 74 ASSOCIATED BUILDING PERMIT#(if applicable): CC C1t 1 E17,1-1J =lJ -E1_ to . x. 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 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 JP 1 1„ fiti aiat LO SY,S`TE 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. City of Everett Official Use Only PERMIT# ,ll•/I' / `g `9 i1 C110-- 3 1 Owner Au horized Agent Signature Date (Revised 10/10/2018)