8401 HOLLY DR 2021-12-10 - Laserfiche WebLink

• OLT PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (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: 8401 Holly Drive EVERETT WA PROPERTY TAX#:28051800201700 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: GRACE LUTHERAN CHURCH TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: sTREET8401 HOLLY DRIVE cITY EVERETT STATE WA ZIP 98208 OWNER PHONE:425-383-1852 OWNER EMAIL:GRACELCMS8@GMAIL.COM CONTRACTOR NAME:SELF CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CHURCH TREASURER CONTACT NAME: CONTACT PHONE:360-722-1205 MIKE RYAN CONTACT EMAIL:FLEETMSTR@GMAIL.COM BUILDING INFORMATION - n Existing Use of Building: !, tt it/fhr-,( Contract Price of Work:$2600.00--� c'1.- Proposed Use of Building:GARDEN SHED &STORAGE Heat Source: ❑Gas ❑Electric ❑Other NONE I `BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ✓❑Accessory Structure Type of Project: ❑New ❑Addition ✓❑Remodel ❑✓Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK:, , T -FROM—THE-£-URRENT O ATFON"0 7G M t_.t TI ex4 ,f Ott s-r t),ILA -v. 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 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 Ventilatior Floor Drain Toilet Exhaust Hood(Type I) r (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/InserULog Roof Drains 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 "/.`, d7-v PERMIT u ...,-..„.....0: l- DO 1 0 ne Authorized Agent Signature Date (Revised 10/10/2018) .7f n.r P1,q,J i, 3•i 5 41,7/t,s" '��.73, .25` 105.i 1 �Y1-1 -4 I