4730 COLBY AVE YMCA 2022-01-11 - Laserfiche WebLink

I 0 PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION OiitjErr. 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: i17 3D COLEY AVE, EvtRE77 wA gin 0 3 PROPERTY TAX#: 29051 i o 0 y LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) E ,4CONTACT INFORMATION' OWNER NAME: YDiNb MENS C NR'S TIAp) ASSOC i/t 7/oN TENANT BUSINESS NAME(Commercial): y,,' A OWNER MAILING ADDRESS: STREET 272o R.oGKE FCLLER AVE CITY VELE7 7 STATE WA ZIP 9 20 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: PL,U013 SIb/JS CONTRACTOR ADDRESS: STREET Qo9 S S . 2Yj71"1 T. CITY TACOMA STATE NA/ls, ZIP 7 eyo CONTRACTOR PHONE: 253 1473 3 3 2-3 CONTRACTOR EMAIL: b A 1 c,n(a P)UM Ls,y i. • L O,r) CONTRACTOR LICENSE#(REQUIRED): Pt//10(j5 I 077 61 S CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): *i$2555 PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253 L -73 1-3 Z.3 BR AN (3R.0SN41Al CONTACT EMAIL: by i qn to rLinbSi,,1S - Cosh BUILDING INFORMATION' Existing Use of Building: 68 j Nu 2SvLYt Pith,A<-'1 SCHoo L. Contract Price of Work:$ 26 /00 • o° Proposed Use of Building:6 9 l nNRSEe'1f peiffut LY, , SLif o0 t_ Heat Source: ❑Gas DElectric DOther 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: INS>At-L (t) DIV FRE(sr&.N,o)NU S WO, (z) DO" Dip EC:71o4,..l kLS t RNo (3) S/P- ILwrnin/A7(o M/fitt,4- S16NS . ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION _- Fixture I m tune 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 I 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 PERMIT# 0 q c 72.2y. 1b ©I_ `1� Ow orized ' Date (Revised 10/10/2018) l/