1916 HOYT AVE 2021-12-22 - Laserfiche WebLink

• PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES @ii4irerr 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 (Mane or• Black Ink Only Pleased G P.O�DECT SIB E ICi`IFOrti@fl6 I IOIN 9PROJECT SITE ADDRESS: 14 1 (.Q I Al/LC Z_ PROPERTY TAX#: (LEGAL for new construction: Shod Plat/subdivision__ j�• Lot No_ (attach copy of long legal description) _ CONTACT INFORMATION OWNER NAME: 0. W,t $#e1.1.Y6-{d I' - TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET I I �IV /l 1� .t Y�ik-r`Q. 'V CITY 5, `�, _ n.C- -STATE ZIP CI g(3 OWNER PHONE: 2O 1.Q ' O q(„QL� OWNER EMAIL: CI CONTRACTOR NAME: bnkil1r CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATI °\I Existing Use of Building: Contract Price of Work:$ Lt 1 Proposed Use of Building: Heat Source: DGas El Electric DOther Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: El Commercial ❑Industrial Type of Project: ❑New DAddition DRemodel DRepair DT.I. ❑Sign ❑Sprinkler DDemolition ❑Change of Use DESCRIPTION OF WORK: p r ( v,st-mAASSOCIATED BUILDING PERMIT#(if applicable): I MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New _ Addn Alteration _Repair Type of Project: New Addn Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling UnitsUnits ,ithattg Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer I Medical Gas Range Hood 1 Water Heater Other: Exhaust Fan I Sink(Service/Bar/Mop/etc.) Other: SPRINKLER I SUPPRESSION SYSTEM Chemical or Water ; 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 be. - .eing 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 w th t - ate Contractors,aw 18.27 RCW and 296.200A WAC. / City of Everett Official Use Only PERM( # Owne'thor`''d Agent Signature Date( (Revise 9/23/2016)