1916 HOYT AVE 2021-12-22 - Laserfiche WebLink

PEMT41ren- 0 APPLICATION. !:UILDING 4 MECHANICAL 4 PLUM:ING 4 SIGN I SPRINKLER 4 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 1 www.everettwa.gov/permits Aue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: I g I L ND(t", A-e. PROPERTY TAX#: 1 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: C Q,t I i s)-1-cu3&id TENANT NAMEy, (IIff Commercial): OWNER MAILING ADDRESS: STREET 1.9"5'111+ Di�R MN)aaki t ) CITY V 1,4 ore l%vla STATE tA3A- ZIP ct I.33 OWNER PHONE: Z-ORk 91214-D OWNER EMAIL: aat ti e I 0 L 1 .G Om CONTRACTOR NAME: owl/Iva-- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: $OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: nf CONTACT PHONE: !-O I 2-xo L 1 Lj-D Oa\I d Q 1,vvvcitij CONTACT EMAIL: BUILDING PERMIT APPLICATION 'sting Use of Building: Contract Price of Work:$ `I" 9.-4 D 0-0 roposed Use of Building: Heat Source: ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project ❑New ❑Addition ❑Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler El ❑Change of Use DESCRIPTION OF WORK: �� S I�� s lJ �.J ASSOCIATED BUILDING PERMIT#(if applicable): ( I - I '-V lJ 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 Units 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 i Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Sink Exhaust Fan i (Service/Bar/Mop/etc.) I Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water INo.of Heads 'ICKNOWLEDGEMENT.:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with ent 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 .lding Official fore being authorized under any circumstance.I am the owner,or lam authorized by the owner of this property to perform the work for which application is made, and I comply w' he State Contra tors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only r ...._/ qi PERMIT# Owne uth rized Agent Signature Dat (Revised 9/2 /2 16)