4924 DOGWOOD DR 2022-06-27 - Laserfiche WebLink

am PERMIT APPLICATION RI BUILDING c•CHANICAL I PLUMBING I SIGN I•INKLER I DEMOLITION 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! www.everettwa.gov/permits (10140i or:Blaok Ink O ly Please),. _..;:PROJEcY SITE.INPO.RMATi t+f.... : .,. PROJECT SITE ADDRESS: I-9a1- hO4 WOON ,RtV PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) :: CONTACT INPQRMATION, .. - OWNER NAME: I_ I Vt P 1 J A P-Vl m So A TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET R 0. i oX C2 4-03" CITY -JVtbtlb4MIS4 STATE piA i ZIP q gal 9/ OWNER PHONE: Y ;,?j2- 34444 OWNER EMAIL: Li idq b 661 0 y4h4'O.COON CONTRACTOR NAME: d UJ V\E., CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER O CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: i 0% STA44114. CONTACT PHONE: 41 — a,-- ,,7„. 44 _4L .Aa/9/ CONTACT EMAIL: RS'AIA)ANX 0 6 A J L•LDIVI Existing Use of Building: R,ES t 6 Y174L S-r12- . Contract Price of Work:$ O1OOG."" Proposed Use of Building: Ri5166,H't-f},L. 4OtAt e.. Sr"- Heat Source: OGas SElectric ❑Other BUILDING USE: '.SFR OTownhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial OAccessory Structure Type of Project: ONew ❑AdditionRemodel ORepair OTA. ❑Sign El Sprinkler El Demolition OChange of Use DESCRIPTION OF WORK: .SEE A11I tiet — .c`EwtOt , LIKE. Foe- L'Ke. 0IJt FghwttoII Fop., IrtLii 't�Yi1 C,LOSCr-- A 80124) w A Le. _ WO") fV.1215. icTG. ASSOCIATED BUILDING PERMIT#(if applicable - :: MECHANICAL PERMIT APPL.LCATIQN PL, 1)4BINGi`PERM9?`!i P'LICA,TION.,_ ._. :; FixtureFklure Fixture Fixture 11 n41 , List of Fixtures Cont List of Fixtures Count ' List of Fixtures Count List ofFtxtures CounttfA "i� NC—Air Handling Units Gas Piping Backfiow Preventer(Inside Bldg) i r Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher 4 Sink-Residential(jkitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,Mop r Exhaust Fans(Residential) Commercial Ventilation Floor Drain X_ 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(Residential) Wood Stove Interceptor-Sand/OII Water Service(behind meter) r tra. Forced Air Systems Other: Medical Gas Water Valves or Fixtures DD Gas Fireplace/Insert/Log Roof Drains Water Heater !SPRINKLER,I SUPPRESSION SYSTEM :::: : Sewage Ejector or Sump Pump Other Water Suppression System I INo.of Heads Chemical Suppression System No.of Heads. ACKNOWLEDGEMENT:I have reviewed this application and confrmi 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!comply wit I Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# q C (4) rciro - ®c3 Owner/Au rized ent Signature ate (Revised 4/15/2019)