2601 LOMBARD AVE 2022-06-28 - Laserfiche WebLink

PERMIT APPLICATIO ,. BUILDING ECHANICAL/PLUMBING/SIGN RINKLER/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 Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: &d i L p tit g¢t-iLy J Tv PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No — (attach copy of long legal description) CONTACT INFORMAt `"*4 OWNER NAME: G fL E GI 5 C.4}(2.,o c p V.B.- TENANT BU/. .. ' S NAME(Commercial): OWNER MAILING ADDRESS: STREET I Co eg 1.0 ddS`t'. A.I E h '` CITY (.AIL-E P"(2.4-3T�Oft(Lc_ STATE ZIP-`g 1SS— OWNER PHONE: (20(;) 3 ( - (,2_7 ' OWNER EMAIL: CONTRACTOR NAME: ,z v t, 1 Zoa a,N e -Z.v.. G CONTRACTOR ADDRESS: STREET 2-2. 11 Co t sT Sr .. S e l 7 CITY �/-i>r.Q.Tc11 STATE WP ZIP'ISZia3 CONTRACTOR PHONE: t.IZS" 35-s Ass CONTRACTOR EMAIL: Q oLPr 06.@4..atkaa.St.Nc-- CONTRACTOR LICENSE#(REQUIRED): A-2.6L Rr g i v$(,t CITY OF EVERETT BUSINESS UCENSE#(REQUIRED): C7>• i 44$( PRIMARY CONTACT: ❑OWNER Ia-CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: t2c' 353--IS 3z I A AJ( SAX 1.G 1,A- CONTACT EMAIL: \\ A a cr,-L- CD GA-S? . t�l i3-'T BUILDING INFORMATION Existing Use of Building: 'T ft..ct.A ')L.,Gy.._ Contract Price of Work: t 2..000 Proposed Use of Building: Heat Source: OGas ❑Electric ❑ er BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU I 1 hilti-Family-#Units: 3 \DCommerci DAccessory Structure ❑ ❑Type of Project: ❑New Addition Remodel Repair ❑T.1. ❑Sign ❑Sprinkler Demo'' n ❑Change of Use DESCRIPTION OF WORK: Chi) 2 c -2 a or - 2 I al e-r 'T/c,( bT�) pp �9(� ?Aa Lo 'p�-a!iM k c P.- - 1 I..�:.}.0 vt 1 i liiv1.e roc7''�.A3 ASSOCIATED BUILDING PERMIT#(if applicable): e rmr E.0 ebit der_m&r✓f , ,CIF j rif 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 Ventilation 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 I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System I No.of Heads ACKNOWLEDGEMENT::!have reviewed this application and confirm the information contained herein is true and coned.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 i comply 'f the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only o / P� '2 a2 D2 • uth�iizzeed t Signature Date (Revised 10/10/2018) il /Z