9929 EVERGREEN WAY 2022-06-28 - Laserfiche WebLink

in 0 PERMIT APPLICATION. BUILDING/MECHANICAL/PLUMBING/SIGN /SPRINKLER/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 I www.everettwa.gov/permits (Blue or Black Ink Only Pleas) PROJECT SITE INFORMATION PROJECT SITE ADDRESS 9 E V,.AC1 csk....J W y PROPERTY TAX#: 0 O9 I3 o oS O 49 Q o 0 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Vt/' I‘;J13--O,/(/' kc(/IA SP.V„`/ ENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET a S—V t. . Si- CITY 5 QA- -‘,P STATE J P- ZIP g 75 l a t OWNER PHONEQ01, -`Qat-3 lit/ ( OWNER EMAIL 0✓/0`I' /aSR'er lt�0 ' Greg^5).tW d^ , , an CONTRACTOR NAME: et fit' P C'11 ...1 N�CONTRACTOR ADDRESS: STREET ! T,,,4A-- ST'A , , P C', CITY ��V)�t.I STATE id A- n ZIP 1%00 I CONTRACTOR PHONE::9g�-,Sc('d 9 CONTRACTOR EMAIL: SL,,Petri --(1)G.4h0-,L. CONTRACTOR LICENSE#(REQUIRED):Abir '4 L�a.31 P CITY OF EVERETT BUSINESS LICENSE#(REQUI S 6 ` PRIMARY CONTACT: ID OWNER CECONTRACTOR El OTHER(Please Specify) ll"" CONTACT NAME: CONTACT PHONE: 0 c' �' .7 c. q O 9 Sc)/ 1 p_,I14(1iJ CONTACT EMAIL: As L, P n- Ca ,,4, BUILDING INFORMATION Existing Use of Building: C vi Pork. Contract Price of Work: ' Proposed Use of Building: Heat Source: ❑Gas ❑Electric Other BUILDING USE: ❑SFR ❑Townhouse ElDuplex DADU ❑Multi-Family-#Units: ercial DAccessory Structure Type of Project: [New DAddition ❑Remodel ❑Repair OT.I. Sign OSprinkier ❑Demolition DChange of Use DESCRIPTION OF WORK:T4S 1 A- 4 C .J.,, L1 ) L E Vj 14,4 % c r 4 o c;,��-0A1 c t k- C'l• J el-..s ' .‘ .Qvt5 FA-C-e- CV14 -S 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 NC—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 Ventilator 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(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System I 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.lam the owner,or I am authorized by the owner of this property to perform the work for which application Is made, and I ply with the State Contractors Law 18.27 RCW and 296.200A WAC. „---- p, `� City of EEvverrett Officialci Use Only 9— er/Authorized Agent Signature Date (Revised 10/10/2018) 112"