3421 NASSAU ST 2022-08-17 - Laserfiche WebLink

• PERMIT APPLICATION SP BUILDING / MECHANICAL/ PLUMBING / SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (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: 3y)._I A 5S u&. $ Eueve-tf W A 48101 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Pckge\ cc,,,0re0.4tCc7 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5A 1.4 __ CITY STATE ZIP OWNER PHONE: 10-5- (2/6$-2$SI OWNER EMAIL: P,c, p„,,e t o oy 1-t'Ct ( a,-OtL/ CONTRACTOR NAME: i3y OC-44e v- CONTRACTOR ADDRESS: STREET , CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ( OWNER ❑ CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: i(ys— g 28 gQ ccl.U2-, �J�V 1 QcILk C!o CONTACT EMAIL: pV . p we( �' 5L�rticlle(t e® BUILDING PERMIT APPLICATION Existing Use of Building: M_ r -- Contract Price of Work:$ S 0c70 Proposed Use of Building: JFZ i, �� a, n Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attach ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: p, v c_ Le5c,C s'to e. ;IA iLk- j Gne.t,-} A c7 ?re vink5 Ow"Ler G g ASSOCIATED BUILDING PERMIT#(if applicable): / MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New_ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #°f List of Fixtures #°f List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pu . Toilet Backflow Prater(Inside Bldg) Forced Air Systems Unit ater Bathtub Urinal Gas Piping B 'er Lavatory(Wash Basin) Drinking-Fountain Water Heater efrigeration Shower Floor'Drain • Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookup-, Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water 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.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 07 �v — ( PERT U) \�� — 0° D"--- Owner/Authorized Agent Signature Date (Revised\\9/23/2016)