5109 SEAHURST AVE 2022-04-06 - Laserfiche WebLink

imi PERMIT APPLICATI in BUILDI'I MECHANICAL / PLUMBING / SIG SPRINKLER/ DEMOLITION e., 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 / PROJECT SITE ADDRESS: S l0/ SF�)ke,(, AVE PROPERTY TAX#: QO Log 00000 2-ix LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: .5o t44-rkf4l✓ _j G7'dt✓ TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 5/0? STAM62 — /V �l CITY ,,,=t../'�/' STATE 1/� ZIP y��v j OWNER PHONE: 20 6 -Z K32 OWNER EMAIL: O fgAtr�62C7,M� L.' . al/1/1 CONTRACTOR NAME: . l'r, C,A_:____/,7FLAS�iI� --14. 0(0 NV1Z- CONTRACTOR ADDRESS: STREET ,/aq ,Alit4 i1 AV7- CITY Vc� (T 1 STATE 1,/,� /•ZIP % 72 Uj CONTRACTOR PHONE: •ZUh �71- g 323 CONTRACTOR EMAIL: f CONTRACTOR LICENSE#(R QUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING INFORMATION tt Existing Use of Building: ,S F 11012(r Contract Price of Work:$ ll_ - ` 37 O Proposed Use of Buil 'rig: Heat Source: ❑Gas Electric ❑Other BUILDING USE: FR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ID1(lew ❑Addition ❑Remodel ❑Repair CT.]. ❑Sign ❑Sprinkler El Demolition ❑Change of Use DESCRIPTION OF WORK: iv e vy DES ASSOCIATED BUILDING PERMIT#(if applicable): 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 Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Ste-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(Residenttal) Wood Stove Interceptor-Sand/Oils ' Water Service(behind meter) Forced Air Systemv Other: Medical Gas Water Valves or Fixtures Gas Fireplace/lnsrt/Log Roof Drains Water Heater SPRINKLE)/ SUPPRESSION SYSTEM Seyage Ejector or Sump Pump Other: Water Suppression Stem 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 l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PE IT# i 0 � 0/ 7 ��O0 02� 0 er/Authorized Agent Ignature Date (Revised 4/15/2019)