5515 BEVERLY LN 2022-06-27 - Laserfiche WebLink

RMIT APPLICATION BUILDIN ECHANICAL/ LUMBING/SIGN I RINKLER/ DEMOLITION EVERETT �'IT" RETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASH INOTON (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: 5515 i3ekf eA\/ LN PROPERTY TAX#:CON/17(oc 7 4$OS LEGAL for new construction: Short Plat/subdivision t Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: i ,t—kowsk( f j ,yt,(1C TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET CITY STATE VA- ZIP OWNER PHONE: l"1 Z 3 601 2f j ZS OWNER EMAIL: r•cl c,ck e ho i 11111"" CONTRACTOR NAME: orM.6 ow r .6— CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: V ,AA C cae ,e— CONTACT PHONE: Z,5 3 3 s L.C 2-44 CONTACT EMAIL: 2 LAA rec 'G,"C -,s1G1°Ls, BUILDING INFORMATION Existing Use of Building: ',FR. Contract Price of Work:$—__ " Proposed Use of Building: Heat Source: ['Gas ItElectric DOther BUILDING USE: §aSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition VIRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Actate tie I v,ez� caw�t Ccrr � ri�' � r�xrv-rS � t�l�c>J Wtvt065 0 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fbctu,e Fixture Fixture Count List of Fixtures coupe List of Fixtures Count List of Fixtures Count st of Fixtures A/C—Air Handling Units Gas Piping Bac• = Preventer(Inside Bldg) 3 S ' ,er,Tub,or Combo _ Boiler Gas Range t Clothes Wa - ink-Commercial(3-comp,prep,floor) I Clothes Dryer i ,_Heat Pump&Ductless , I Dishwasher Sink-Residential(kitchen,bath,bar) _Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop —14_Exhaust Fans(Residential), Commercial Ventilatior Floor Drain . 3 Toilet _ Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal _Exhaust Hood(Type II) Water Heater Interceptor-Grease aste/Water Piping Repair —I Exhaust Hood(Residential) Wood Stove Interceptor-Sa : Oil - Service(behind meter) I Forced Air Systems Other: Medical G-- Water -s or Fixtures Gas Fireplace/Insert/Log Roof D ins I Water Heater SPRINKLER/SUPPRESSION SYSTEM S= age Ejector or Sump Pump Other: Water Suppression System No.of Heads • Chemical Suppression System I lNo.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.lam the owner,or lam 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 Ofcial Use Only PERMIT# y\ fL\ 0 2/....024 \ CAdva,C Aree.4 er CO/g/2-C) Owner/Authorized Agent Signature Da (Revised 10/10/2018)