5515 BEVERLY LN 2022-06-27 - Laserfiche WebLink

MI PERM ' - (CATION Aik BUILDING APECHANICA I SIGN I WRINKLER/ DEMOLITION EVERETT CITY O Y -E `ERMIT 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: 6515 `3i J t Y \( UN PROPERTY TAX#:C.61- J/ ?ooa co 4 SOS LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: i ,/--kotsl f\7,,a'5 i vt.tie£yA-, TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ' ZIP OWNER PHONE: I H Z 5 60( '2'j Z j OWNER EMAIL: ry f CONTRACTOR NAME: �rf\,6 oweve,- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: Ya,,,,A C. Vae— CONTACT PHONE: Z5 3 3 2_(2 44 CONTACT EMAIL: 2 t,,`0 fr - ,.ztes1 yti BUILDING INFORMATION Existing Use of Building: S FIB Contract Price of Work:$ c Proposed Use of Building: 4 Heat Source: DGas ItElectric DOther BUILDING USE: t5aSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ['Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition l Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Addtv..15 eel 1 V1 ec_t3 caw t Ge,rcviv c ert+- 0,c erx:)rvs / (l&t.- 1}4,1065 ASSOCIATED BUILDING PERMIT#(if applicable): '\-- —C&A'C MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Cr List of Fixtures count List of Fi• res Count List of Fixtures Count List of Fixtures C—Air Handling Units Gas P' g _Backflow Preventer(Inside Bldg) 3 Shower,Tub,or Combo _ Bol _ Range 1 Clothes Washer Sink-Commercial(3-comp,prep,floor) _ I Clothe ryer — Heat Pump&Ductless , 1 Dishwasher Tj' Sink-Residential(kitchen,bath,bar) _ Duct Syste -emodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop _ 14 Exhaust Fans(R- ".ential Commercial Ventilatior Floor Drain 3 Toilet _Exhaust Hood(Type I (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(T •- II) Water Heater Interceptor-Grease Waste/Water Piping Repair —1 r Exhaust Hoo. residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) l' Forced Air-ystems • ,-r: Medical Gas s Water Valves or Fixtures Gas F place/Insert/Log Roof Drains \ 1 Water Heater SP' KLER/SUPPRESSION SYSTE Sewage Ejector or Sump Pump Other: Water Sup. -ssion System No.of Heads Chemical Suppression System , INo.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 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 L�C Aiec-xter (pPERMIT/ n O l 5t)1 /q/z O rL Owner/Authorized Agent Signature Da (Revised 10/10/2018)