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6829 BEVERLY BLVD 2022-04-04
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6829 BEVERLY BLVD 2022-04-04
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Last modified
4/4/2022 9:56:09 AM
Creation date
4/4/2022 9:55:42 AM
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Address Document
Street Name
BEVERLY BLVD
Street Number
6829
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NMI PERMIT APPLICATION <br /> BUILDING fliCHANICAL/ PLUMBING I SIGN I ApilNKLER I DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only,Please) PROJECT SITE INFORMATION <br /> Z PROJECT SITE ADDRESS: � ' ,(��,' - (t b 1 ocQ PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: %P E S 5300 Li-C. TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 770)( IJ.'Z 2— <br /> CITY D( i I I (-Yee- STATE Ci2)-f1 ZIP CJoe z_. <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 12-0WNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: c1tq 9( <br /> 3 - c 2 ��e ( W GYI S CONTACT EMAIL: ci c3 Li-� G yYLC(. I. C.!_L yb'L <br /> BUILDING INFORMATION <br /> Existing Use of Building: s• ;=2 Contract Price of Work:$ ��;� <br /> roc.`= <br /> Proposed Use of Building: 5 ,' /Z Heat Source: ❑Gas El-Electric ❑Other <br /> BUILDING USE: 14 SFR ❑Townhouse ❑Duplex ❑ADU 0 Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition IIRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler CI Demolition El Change of Use <br /> DESCRIPTION OF WORK: - <br /> vtnoue cell d� 'e � � ( - tr- ve � i ,.c-v�e c9ezz <br /> �a ( vi a-'c e,k_ - V e4O ro o wI 'I-6 5 a i T k ct$ oei Tve 554- e <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior\ Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System No.of Heads <br /> ACKNOWLEDGEMENT:/have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> 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 <br /> Building Official before being authorized under any circumstance.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT#u <br /> Owne 7AuthO ed Agent 5i nature Date (Revised 4/15/2019) <br /> [ � 9 g 12_ <br />
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