1713 BAILEY AVE 2021-11-10 - Laserfiche WebLink

MIMI PERMIT APPLICATIO D BUILDINGSIECHANICAL / PLUMBING / SIGN RINKLER / DEMOLITION EV E R E T T 32 0 CITY OF EVERETT PERMIT SERVICES CEDAR STREET, V RE T,WA 98201 petted DO Lief goo WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits 30 ( 71)Z7 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: I 13 eq,i f Qy f v-e PROPERTY TAX#:COs��0 ' \.— >� LEGAL for new construction: Short Plat/subdivision / Lot No. (attach copy of long legal description) CONTACT INFORMATION , OWNER NAME: MCgeMl ) WI Gtl2IVI ci GISeCa TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET I1 L3 �3,/a (ey AveAvl Everr� Q'8ac3 -'/'J.r� CITY a'J�I-E /f/• / SIAIE ZIP OWNER PHONE: 8 25 Li 0 3 06 8 I OWNER EMAIL: O' fY) C ke v c i 5 N . G ' -' CONTRACTOR NAME: K e till Pots (as c3ok/etri /4Lp'4e £ O .S /lc.. CONTRACTORADDRESS: STREET bS ^� CITY /y�t,J P_fl'ei STATE W � ZIP 7$dO6 CONTRACTOR PHONE: t{T j —L `g aO' CONTRACTOR EMAIL: KKi.+1'Fe II pe tp ,st€4 r . Gem.A. CONTRACTOR LICENSE#(REQUIRED): 1i-L.P.tN R L 1567 1 ‹ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): L`% L4 PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: l?JG 47 8 020 Z tCP K. .0 O 1L a.5 co CONTACT EMAIL: 1,,e 6Th e Cape s . BUILDING INFORMATION Existing Use of Building: S r Contract Price of Work: $ Z 30l,DO0 ' �i Proposed Use of Building: 3 4 � Heat Source: OGas DElectric - . DOther N ON , BUILDING USE: 'ASFR ❑Townhouse Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: New XAddition Remodel ❑Repair ❑T.I. Sign Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: E (40SQ40 &n f y 'i#0 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures I 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-Grea Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-,Stand/Oil Water Service(behind meter) Forced Air Systems : Other: Medicaly9'2rs Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Dfains 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 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# it./. I�� Øv/&' '� I 0 3- CD 8 Owner/Authorized A.�'t Signature Da (Revised 10/10/2018)