1514 GRAND AVE 2021-11-12 - Laserfiche WebLink

i ® 0 PERMIT APPLICATIO4 ' 112 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) p PROJECT SITE INFORMATION PROJECT SITE ADDRESS: II 1 14 G-fZAt\ ANI C ,E.0 1 1 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Dakte --i--Peo y .Kkkr t2 TENANT BUSINESS NAME(Commercial): (*fad OWNER MAILING ADDRESS: STREET I 4 A V a /�/ G° �CITY ev, Q STATE ' v it ZIP qp -b I r�cc OWNER PHONE:4Z —2 -ZS6 D /_ OWNER EMAIL: -tE 3 y Iur�@die.Cowl CONTRACTOR NAME: f G1 oeo�jc Cthd(CFt 0(,'11z7i+f C 1 ivej -- ✓evel O p Ol l t Li-C_ .J ) C� CONTRACTOR ADDRESS: STREET oJJ VV1OY. 1 s BPS �syana]>i 1,1 fC If WA S1Kr) [X)GQ STATE W/- ZIP Cid 0 -7?_- CONTRACTOR PHONE:Z( —2q0 -38-L6 CONTRACTOR EMAIL: ri'✓e V (con (+t''S Ccd / f CONTRACTOR LICENSE#(REQUIRED): 17 H-OE NCC-RDcC K CITY OF EVERETT BUSINESS LICENSE#(REQUI ED): PRIMARY CONTACT: ❑ OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT� _ NAME: CONTACT PHONE: 2 ' --2-7 v .WE� f alrne y: 1-T''�SeV) CONTACT EMAIL: t---iveYSOnci con gLeiflf— �cfyvrarl • 60/YJ / BUILDING INFORMATION J Z Contract Price of Work: $ c2 — Ck 3 � Existing Use of Building: ��( - Proposed Use of Building: S E-12, Heat Source: ❑Gas L1eectric ❑Other BUILDING USE: EaSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ONew ❑Addition ❑Remodel aRepair DTI. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: j e yyia%,2 ex 1 si-r� e C k -f- k v h "fiu to , --MS-i-- ed 1 o e7 66 de c 5#4 i r,: ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION „,-/ Fixtu Fixture Fixture Fixture List of Fixtures Count List of F" ures Count List of Fixtures Count List of Fixtu Count A/ Air Handling Units Gas • ing Backflow 're enter(Inside Bldg) Shower,Tub,or mbo 3oilr s Range Clothes Washer Sink-Corn rcial(3-comp,prep,floor) Clothes Drye Heat Pump&Ductless Dishwasher Sin esidential(kitchen,bath,bar) Duct System(Re •del) Refrigeration Drinking Fountain ink-Utility,laundry,mop Exhaust Fans(Reside 'a Commercial Ventilatior Floor Drain Toilet Exhaust Hood (Type (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(T .e II) Water Heater Interceptor-Greaseaste/Water Piping Repair Exhaust Ho.: (Residential) Wood Stove Interceptor-Sand/Oil WaferS.ervice(behind meter) Forced Systems er: Medical Gas Water ValVes,or Fixtures Ga ireplace/Insert/Log Roof Dr • Water Heater INKLER/ SUPPRESSION SYST age Ejector or Sump Pump Other: Wat uppression System No.of Heads NNN emical Suppression System i INo.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 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 296,200A WAC. City of Everett Official Use Only PERMt��D 03- C � � G 2% Z i J /`lf/.��i (1� 11 Owner/Authorized gent Signature Date (Revised 4/15/2019) /Z