2111 ROSS AVE 2022-02-15 - Laserfiche WebLink

. • • PERMIT APPLICATION + BUILDING 1 CHANIC.AL l PLUMBINt I SIGN MI~ I SPRINKLER/DEMOLITION • �4 CITY OF EVERETT PERMIT SERVICES Nitiial- 3200 CEDAR STREET,EVERETT,WA 98201 (P)426-257-8810 j FAX 425-257-8857 j(E)everetteps@everetfwa.gov I www.evereftwa.gov/permits . (Iblyd®*®tr iskkck Ink kink efe2ise) • • PROMO'SII•'TE 1114F®OMIATt'lOiR .. • . PROJECT SITE ADDRESS: g.( PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of tong legal description) • COMTAdTiM ®l, Gt TIRM OWNER NAME: Its`k't` jam¢-E-ra.LG(70)JTENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET `s 2....5 . l -(-N It A.../0- CITY elril t R Ci-C STATE (AVM-. ZIP q 0 Zo OWNER PHONE: 34 D) 7I3 •- Zit• OWNER EMAIL: • CONTRACTOR NAME: E U-C .6V.- d i J 6 `DrTt( flea-i'4 r - CONTRACTOR ADDRESS: STREET --t .- P >. AU g , CITY Fa() STATE (,(J- zip 6 Pa 20 • CONTRACTOR PHONE: 4??5,-2.5 2.. j//4 • CONTRACTOR EMAIL: , CONTRACTOR LICENSE#(REQUIRED): EVIR26..js ip2 Gp^i!'• +CITY or EVERETT BUSINESS LICENSE#(REQUIRED): 69 6--/t ej' ,.....-..w ...awr�-*.+-.,. y�.v, v..nv.M.e- �w w«y.,. �e ..•n+n.•...S+.�M r....,.«ww«n.a.....i2w.w�ww•.M..i-M.r • s..w.... .sc..e.rvvw..y-n.vy+ .1+ I .rwu... w..-k...Wn.....w.s.rwnr.«..�v vM-w w w-•+ . PRIMARY CONTACT: ❑OWNER 1aCONTRACTOR ❑OTHER(Please Specify) • CONTACT NAME: CONTACT PHONE: 4 7 c_s5r2,.r,/f 9 l 1 e t.v CONTACT EMAIL: _ : , , .. bUIL.hIMGPkR.IilTAPPLICATI®h( • • . ., Existing Use of Building: Contract Price of Work:$ =- 1 .11.11111111 Proposed Use of Building: Heat Source: ❑Gas :Electric ElOther Building Type: ❑SFR Defached CISFR-Attached ClDuplex DMultl-Family-#of Units: (Commercial Ulndustrlal Type of Project: CINew ElAdditlon ElRemodel IRepalr CiT.I. ElSign ❑Sprinkler I:Demolition ❑Change of Use DESCRIPTION OF WORK: (ZLP(✓{C i (AJA lfri vui.sctG)) A-II✓' c- ice' -''--p r-JL`1— • ASSOCIATED BUILDING PERMIT#(if applicable): - 41l:CA 0ERIilliTAPPLICTGOk� , PL UMd9 [F PRiitiftAPPLLICATI®) •McA Type of Project: „New_ Addn Alteration_,Repair j I Type of Project: New Addn Alteration Repair #of • Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures A/C-Air Handling Units Heat Pump i Toilet • Backflow Preventer(Inside Bfdg) 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 Medical Gas ' Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: . :..§1 RW fK LIER J A l il•EMB SYSRhMUf • ' Number of Heads MOWLEDGEMENT:I have reviewed this application and confirm the Information contained herein is true and correct.Work done pursuant to this permit must comply with crest federal,state,and local law.The granting of permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the ilding Official before being authorized under any circumstance.I am the owner,or am authorized by the owner of this property to perform the work for which application/s made, d I comply with the State Contra ors Law78.27RCWandd�90.200A WAG City of Everett Official Use Only / pErvit 4 (O` q- ner/Authorized Agent Signature Date (Revised 6/20/20/6) _