1110 POPLAR ST 2022-07-27 - Laserfiche WebLink

PERMIT APPLICATIOA MI BUILDIN MECHANICAL / PLUMBING / SIGNMPRINKLER/ 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: (\) Fcelar 5 -eej !fQ.N' PROPERTY TAX#:v1%5j I1 861) LEGAL for new construction: Short Plat/subdivision Pr Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: __'\fU,(e,A Sd) Isi-r)Gl- L TENANT BUSINESS NAME(Commercial): ' harne ,e le. .fr'y M OWNER MAILING ADDRESS: STREET 141 b C_o t by hre-ma e / CITY Mai+ STATE wr- ZIP eN203 OWNER PHONE: 4a6- 385- Lox OWNER EMAIL: V.(Ny )4 S r T e(/.ere--1-sd. D j CONTRACTOR NAME: Meta &41h CD � iin(:. . CONTRACTOR ADDRESS: STREET r (Q pg � I CITY f Vann()n() STATE jj,Wl ZIP l i27 3 CONTRACTOR PHONE: ,31p0— 4au— [3a5 CONTRACTOR EMAIL: It emek r5,5n,rW CONTRACTOR LICENSE#(REQUIRED): (V1 q?r 55C?3 Z3$ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 5731 0 PRIMARY CONTACT: ❑OWNER F NTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 31,0 _Log_ 13a 5 k1Yul e CONTACT EMAIL: P2rm 11a& YYle I t,r51 /),t_i BUILDING INFORMATION Existing Use of Building: 501001 Contract Price of Work:$ _ ra po Proposed Use of Building: , Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ''Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 1)1ew)D'a _ell 5,1 IAAi) Si 0h MI r raSa,te Cme size) w1/4-ill fl& ry E Saye Cen-ler 4- .p Cttbind- ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of ' tures Count List of Fixtures Count List of Fi ures • A/C—Air Handling Units Piping Backflow Preventer(Inside Bldg) Shower,T ,or Combo Boiler Gas Range Clothes Washer Sin mmercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher ink-Residential(kitchen,bath,bar) Duct System(Remode Refrigeration Drinking Fountain Sink-Utility,laundry, mop Exhaust Fans(R . ential) Commercial Ventilatior Floor Drain / Toilet Exhaust Ho (Type I) (Not Heat/AC system) Hose Bibb Urinal Exha ood(Type II) Water Heater Interceptor-Grease, Waste/Water Piping Repair Lust Hood(Residential) Wood Stove Interceptor-Sapd10i1 Water Service(behind meter) Forced Air Systems Other: Medical as Water Valves or Fixtures 777 Gas Fireplace/Insert/Log Roo rains Water Heater SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 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.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 with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 4t,Ln PERMIT# (- Jvcin-c I e _ a- 1 -a 1 S 7-- 10 — 0 0 3 Own /Authorized Agent Signature Date (Revised 10/10/2018) Ik