5109 SEAHURST AVE 2022-04-06 - Laserfiche WebLink

� PERMIT APPLICATIO BUILDING`1 iI1ECHANICAL/ PLUMBING /SIGN RINKLER/ EMOLITION 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.e rettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: ri 0? a�i�N1cger7--- ,M V(E PROPERTY T X#: IO''//6 OOOO O/Oa LEGAL for new construction: Short Plat/subdivision Lot No. (attach cop7 of long legal description) CONTACT INFORMATION OWNER NAME: 501,./AMA4,/ j i J� TENANT BUSINESS AME(Commercial): OWNER MAILING ADDRESS: STREET 5/09 A r ii � ,nn CITY /��. j�- //�1,, � STATE Wj--F ZIP 72O3 OWNER PHONE: 206 -29_ ' 323 OW EMAIL: OAvl�i` i) Q ffffff6/4,tit176- r CONTRACTOR NAME: iatJ CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONT CTOR EMAIL: CONTRACTOR LICENSE#(R UIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: OWNER 0 CONTRA 0 OT R(Please Specify) CONTACT NAME: \ 1 ONTACT PHONE: 0)-'/.{01A,1✓ /CONTACT EMAIL: B LDING INFORMATION Existing Use of Building: Contract Price of Work:$ 2 -9-)C LA LJ ) Proposed Use of Bui ng: ez442446e. Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: FR ❑Townhouse El Duplex IIADU ❑Multi-Family-#Units: ❑Commercial ,ccessory Structure Type of Project: J?New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: J/t pC-riee/40 6,4466 ASSOCIATED BUILDING PERMIT#(if applic..le): MECHANICAL PERMIT APP ICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures coon 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 Ventilatior 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(Resident':I) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/InserUL.. Roof Drains Water Heater SPRINKLER I SU'PRESSION 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 o /t7a / �' P ERM O '�'O2 � Ow r/Authorized gent Signature . (Revised 4/15/2019)