9415 1ST DR SE 2022-03-03 - Laserfiche WebLink

mil PERMIT APPLICATIO ILE BUILDING ECHANICAL I PLUMBING /SIGN / RINKLER I 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 a LiPROJECT SITE ADDRESS: /7/fj /d(j PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: //. / Q (Lv,i,b%N TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET (4Lj/`j I c i c-.5 a tI '/ CITY 7 \J pr-7 STATE ZIP 7Sj� OWNER PHONE: 4as 7 ,9 1/b / I..w OWNER EMAIL: / CONTRACTOR NAME: &t) 1-4-eit I-fliv d- ,I L_LC c CONTRACTOR ADDRESSl STREET sod-ea/7 I(8a`7 _ 'J dr $E1 CITY 1 STATE G.44 ZIP 9 °7 CONTRACTOR PHONE: 4775 7 2 0 9 p, CONTRACTOR EMAIL:SG e,/,¢4/1 di G J YI//. C�H? CONTRACTOR LICENSE#(REQUIRED): t- [ i-tC S'l b ( N CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) , PRIMARY CONTACT: Er()WNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (�),c y3 p /6 7/ M C�C4/lN CONTACT EMAIL: BUILDING INFORMATION Existing Use of Building: P' 5;Q.I pJ(ie. Contract Price of Work: $iJuil�_5U t©P t 2` Proposed Use of ' g: Heat Source: ❑Gas LcJElectric ❑Other BUILDING USE: L house ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ■New DAddition El Remodel ORepair CIT.]. ❑Sign ❑Sprinkler 0 Demolition ❑Change of Use DESCRIPTION OF WORK:At lAG 4 i ,I Fi-r1 ASSOCIATED BUILDING PERMIT#(if applicable): i. l(.)6 1-0,1 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 y, 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. / l/Cityy of Everett Official Use Only PERI)Q 7� V _..,VU1 Owner/Authorized Agent Signature Date (Revised 4/15/2019)