6110 COLBY AVE 2022-04-04 - Laserfiche WebLink

PERMIT APPLICATION BUILDING CHANICAL/ PLUMBING /SIGN /WINKLER/ DEMOLITION 4en. CITY OF EVERETT PERMIT SERVICE 3200 CEDAR STREET,EVERETT,WA 98201 (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: &#'O C A6• j f ' i/ae" PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) -_ _ - CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADbRESS: STREET yy,.��61 i 0 �Lt4 5 CITY .�J.v{9 '°1i' STATE IMOt ZIP i 1 OWNER PHONE: 100,1 l l-- Oct OWNER EMAIL: oro koon 03 eilue,raC�S�y> Cxt. CzIA� ` CONTRACTOR NAME: E _ l� g "k -- -j CONTRACTOR ADDRESS: STREET 444 14495 4 7 - 5 V15*. ST'• a CITY s U)STATE PI ZIP 1 8 t eg CONTRACTOR PHONE: le(f . BSI - fel+ri CONTRACTOR EMAIL: CI CONTRACTOR LICENSEJ#(REQ�UIRED) CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): "'r 152� PRIMARY CONTACT: O� WNER ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 010(e . 71+1 ()SAL'. 600 6G UMPI CONTACT EMAIL: brojo0telgeluefroe G�„e,,:I• C.t v3 BUILDING PERMIT APPLICATION I`�'�"`` Existing Use of Building: 12gLiTint CNAc Contract Price of Work:$ 361 efe Proposed Use of Building: 4u 6 icuc Heat Source: ❑Gas ❑Electric "❑Other _ Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: Wkommercial ❑Industrial Type of Project: ❑New ❑Addition VRemodel ❑Repair ❑T.I. ❑Sign CI Sprinkler Demolition ❑Change of Use DESCRIPTION OF WORK: p ,kouset% blacosies Nuix..9 , crm vvialit4 Ronc. mo0i05 tiyiN oFf.,ce5 _oll/1_G1914- *3141Liasi4S IeeY°« ti' 14 Ci11.1l 1 . vwgibricwisas hp tit otrufZ s • KOPlii Mkt. a lS A9Pr turincoorx, Kr ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn ^_Alteration .•air Type of Project: _New )LAddn _Alteration _Repair #of List of Fixtures #of ist of Fixtures #of List of Fixture #of List of ' ures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump _Toilet Backflo reventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Ur' Gas Piping Boiler Lavato,gy( sh Basin) rinking Fountain _ Water Heater Refrige n Shaoder Floor Drain Gas Fireplace W a o i I)fchen Sink&Disposal Grease Trap Gas Range IT' I g c e: Dishwasher Roof Drains Clothes D,,er Hookups ,‘_ other: Clothes Washer Medical Gas _ _ Range . ood Water Heate Other: Exhau Fan , _ Sink(Se,- ce/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water ' 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 1 D/4 117 PERM , \ LJ -- bi i Owner/Aud o izer ge Signature Date (Revised 9/23/2016)