2215 PINE ST 2021-12-10 - Laserfiche WebLink

IMI • PERMIT APPLICATION • 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) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: Z 2 I b Fl AI E_ r , PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 1r\JT •t'I^,00L D,T-F,T TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET j 7 0 .6 CA 1 \"/A 7 r41, . CITY r- I/fi h rT ` STATE WA ZIP 90/w OWNER PHONE: f ZS-- 3es - cc OWNER EMAIL: p Y'I C. 1 'e r2VCV'C d ,crc CONTRACTOR NAME: L B C Co✓i 5 V✓Lir,1-I (i'1 9 CONTRACTOR ADDRESS: STREET 6!/2 4 L ) 7 41- jL / /E r� CITY 5 LE l/(/ STATE WA- ZIP �(�U06 CONTRACTOR PHONE: 2_06,- 47 _ 'lj--. ire CONTRACTOR EMAIL: h,Gl Ito in ( )ay5011 ix r Cr Cc , 60l41 CONTRACTOR LICENSE#(REQUIRED): L5C 0G 463 N'&i CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)(sD?/t"p PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR pt OTHER(Please Specify) A-rC. l I `e C f" CONTACT NAME: Al I Ie5 \ M'kc CONTACT PHONE: .1z.5- Z<'C/ - og(ve 6N k A2c. 1i 1 , (7 5 CONTACT EMAIL: pyi Jese jjll f') C(✓'C L'1 ; L ct;,i BUILDING INFORMATION Existing Use of Building: Jr,�ioC / 'Contract Price of Work: $ 9 s'� 2 S O Proposed Use of Building: ?GbCC/ Heat Source: —Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ,2tRemodell ❑Repair ❑T.l. ❑Sign Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Rack i k Gut U`i G` j/It;,u W c,t l 1 A-- c1 .r oo sh y j� c /\.V►'ainC� l� / c.0Y 1vtcre-c`-S64 Secc-,v-I /, 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 Ventilation 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 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. /11 City of Everett Official Use Only 10//___ r 0 11 r 0 r/Authorized A ent Signature Dat� PERM!(Revised 1 /10/2018) yz-.