1030 HOYT AVE 2021-11-15 - Laserfiche WebLink

NOM .� PERMIT APPLICATIOIlik 112 BUILDING'�tiAECHANICAL/ PLUMBING / SIGN WRINKLER/ 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 INFORMATION PROJECT SITE ADDRESS:*' ,C)Jc) /` GLy�� PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision LJ Lot No. (attach copy of long legal description) CONTACT INFORMATION 4i ►OWNER NAME:c/ 0(2a.) ' i`)U 0Sci TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET /)L,c2._ CITY STATE ZIP OWNER PHONE: OWNER EMAIL: viz CONTRACTOR NAME: ivY7 !'C46 Zo}144 d hie? (� ,6 CONTRACTOR ADDRESS: STREET I O t /C�j/ — //��/�, c1 // CITY St ` 61() STAT��/4)/ ZIP / 0 pC /C CONTRACTOR PHONE6C).73/S 33 \ CONTRACTOR EMAIL: �t.0&,tiY,Ytdkou l%/liPl5/JW;)'7,0 p J// CONTRACTOR LICENSE#(REQUIRED) yAo 6' (�'ci a © / CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): S—S- 1L""J PRIMARY CONTACT: 0 OWNER �CONTRACTOR 0 OTHER(Please Specify) CONTACT NA CONTACT PHONE: I•Q�,3 J j-�a-36 /�/�� k..)10- s/A) CONTACT EMAIL: `F 1 far /' BUILDING INFORMATION `, Existing Use of Building: Contract Price of Work:$ 6�-� Proposed Use of Building: Heat Source: ❑Gas 0 Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU El Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: CI New ❑Addition ❑Remodel El Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: NI I p WGt ai R.e,s l h 1121 l ii 41, 4 wa,6 it W ✓.-ft mg ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) l Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher 2, Sink-Residential(kitchen,bath,bar) 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 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 1 Water Heater SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump I Othe -Q�bl Water Suppression System No.of Heads Chemical Suppression System No.of Heads ��iYY 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 loca 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 bein a thorized 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 St C.ntractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only iL PER7,2a) wCA Owner uthorized • A Signature Date (Revised 4/15/2019)2.C)O _ t