10817 HOLLY DR 2021-12-22 - Laserfiche WebLink

® PERMIT APPLICATIOS 1110 BUILDIN 0MECHANICAL I PLUMBING I SIGN i PRINKLER I 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: /023 l - he //V fl r j/epi-a.�.{ PROPERTY TAX#: cc9 e,C"�•2-9 G G2v r,1*v LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: /��/./t4-1�)v ,. c)1// f(-i -1 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET /02 /?- 6)iiy yf)Y CITY e:ve,rei/ STATE /Ai;,A0 ZIP —/ 2CJ (I OWNER PHONE: ,06 ,ve=57 2'z OWNER EMAIL: 7'2 1.D ,,,r f�c.26�ls /n.„_r c ., k', CONTRACTOR NAME: � ...11_,Are,__- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ��) �' - / S -.C2)2Z r keee4-t--)ci , cf-/'/A-ce.4,- -) CONTACT EMAIL: 7'06 1/0200K G--, ''/- co» BUILDING INFORMATION _.-- -----, --- _ Existing Use of Building: Contract Price of Work. L, Proposed Use of Building: Heat Source: OGas Electri ropo g c Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU DMulti-Family-#Units: DCommercial DAccessory Structure Type of Project: ❑New DAddition El Remodel ❑Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Acou c.v..- poot,„,..„-:L./ i 0 of e ,i/7/e cd-,:v ea ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture List of Fixtures List of Fixtures List of Fixtures List of Fixtures Count Count Count Count .� A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Corbb 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) Refr,erdon Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) rtimmercial Ventilation Floor Drain _ Toilet Exhaust Hood(Type I) f�(Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) V Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Resider� 1) Wood Stove Interceptor-Sar�d/01/ Water Service(behind meter) Forced Air Systems Other: Medical G Water Valves or Fixtures Gas Fireplace/I ert/Log Roo ains Water Heater SPRINK I SUPPRESSION SYSTEM ewage Ejector or Sump Pump Other: Water Suppressio ystem No.of Heads Chemical Supp ssion System No.of Heads ACKNOWLE GEMENT: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 PERM piz-t--.."-e-f— ---.,— ie.2Ao/2._ =-)/ , ,ck k 2,-003 0 er/Authorized Agent Signature Date (Revised 4/15/2019) C O