1715 RAINIER AVE 2022-01-21 - Laserfiche WebLink

PERMIT APPLICATION ni BUILDING CHANICAL/ PLUMBING /SIGN / INKLER/ 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: j ' /5' r;t n C r cA,Ut, 'v fr-e-1-4. `,,/A PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: i a�\n, Cy rb�0r- 11' PA yirteAgg B11865//S NAME(Commercial): OWNER MAILING ADDRESS: STREET 11,543 1 ft" tcU,,,_ N;N' CITY S tNd-T IC STATE VA ZIP IS 6 / 4 OWNER PHONE: ZD 6 `7 20 06 I1 OWNER EMAIL: J, t,f- y y r 1-(411)c ✓•4` / C o"1 CONTRACTOR NAME: NA CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: C` OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: jv�c(,‘ yr,�c,7 CONTACT PHONE: ;1 c c,u; ©O / 7 CONTACT EMAIL: ,J, ; c.' c-y i'-ea)7 7-r-dr• 0.'I--„'( C,o v„. _l s1 BUILDING INFORMATION " Existing Use of Building: (10,�, N_,. Contract Price of Work:$ ' tt'3(. 000, (9 Proposed Use of Building: I L Vr f 3 Heat Source: Gas DElectric ❑Other BUILDING USE: gSFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition El Remodel CI Repair ❑T.I. ❑Sign ❑Sprinkler El Demolition ❑Change of Use DESCRIPTION OF WORK: p, ci..‘ C.A.v‘ i�h . s bH3 L v-ve 1,1 4 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. ,fCity&of EE)verett Official Use Only 77 PER / t,7- --- a-/10 )NO Owne Authorized Agent Signature Da a (Revised 4/15/2019) i fL