9308 9TH DR SE 2022-01-21 - Laserfiche WebLink

PERMIT APPLICATIO BUILDING.ECHANICAL/ PLUMBING /SIGN RINKLER/ 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: C,.3 r U 7J)- D Q ,S PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: f b w1.( C0/4 S-1L()G,T(Cr1 (�t,ty TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET t oI C, N-CIZcZ(Z(� ,}�(Z c ( CITY M L([ C R-(y �E STATE L491 ZIP 78 C Z OWNER PHONE: CS OWNER EMAIL: -IiZ/ST CONTRACTOR NAME: .SP-,/!1(L: /4S- /36Lf CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER cg CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ,Z (. -- L/to e e/ Ci-1 1)4j (O bL1rY CONTACT EMAIL: Cel.IZU!'d VH,.:i UrOt.��^ (w t,J) jIL CO/2-i BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ ire& Proposed Use of Building: Heat Source: ❑Gas 13Electric ❑Other BUILDING USE: 159SFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: El Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ORepair ❑T.I. ❑Sign ❑Sprinkler El Demolition ❑Change of Use DESCRIPTION OF WORK: rs 'l t,��l/� IJ/). 1267 )r-( 1-4 /4u4 �— CI'z/L�prs ilYTCtttz /�fTAd� tiiew AtOp145 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 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 7 -(6 -7 7 PERM! V �t)-1,... o \J; Owner/Authorized Agent Signature Date (Revised 4/15/2019) ra