2616 HILLSIDE LN 2021-11-12 - Laserfiche WebLink

• • iIII PERMIT APPLICATION BUILDING/ MECHANICAL! PLUMBING l SIGN /SPRINKLER 1 DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-881D I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Pleaso) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2-CID I Co H I ti lck LA.t1v PROPERTY TAX#:00SG19(}U 20 0 5 t} LEGAL for new construction: Short Plat/subdivision __._ Lot No. _ (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: ffi j Cilckie 1 Trc r + TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 2-00I to ' k,`,1 e Lc,r1 e., y cm? E et el* _ STATE )1 cj C ZIP ,0 OWNER PHONE: 4.2S--3Sj- ({ L% OWNER EMAIL: Ad-rent- CCmCc,s,r ne 1 CONTRACTOR NAME: \ANS-kliki SO 1Ttoc IA( CONTRACTOR ADDRESS: StREET Sy jy t 1 ,,L , > GN Belk; 116.r". STATE ,(, , zip n G f. CONTRACTOR PHONE: 3( C) 124(. 071S-9 CONTRACTOR EMAIL:i(\TA CI LARAI.eir riSaltity-t nt.. Cc A, CONTRACTOR LICENSE#(REQUIRED): ar( Sa y CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): OS tits " PRIMARY CONTACT: ❑OWNER )`"CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 1 )•-1t,1 Cp, ( s s Ci r"pY }{ geeC`-e le- CONTACT EMAIL: c} c91 wesltxttSplcn.rii\t ,torn BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ 4 a Proposed Use of Building: Heat Source: ❑Gas DElectric DOther BUILDING USE ❑SFR ❑Townhouse ❑Duplex DADU CMulti-Family-#Units:— ❑Commercial ❑Accessary Structure Type of Project: CNew ❑Addition DRernodel DRepair DT.l. ❑Sign DSprinkler DDemolition EChange of Use DESCRIPTION OF WORK: 5 H SSo lcLY i V S-46 . ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Coon! 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 V Boiler Gas Range _ Clothes Washer Sink-Commercial(3eomp,prep,flenr) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,barl 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 WasteiWater 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 il SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other. Water Suppression System No.of Heads Chemical Suppression System No.of Heads ir ACKNOWLEDGEMENT:t 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!am authorized by the owner of this property to perform the work for which application is made, and!comely with the State Contractors Law 18.27 RCW and 296,200A WAC. City of Everett Official Use Only .-- PER q I O J O0� OwnerlAuthorized Agent Signat4,-- Date (Revised 10/ 0/2018)