1423 VIRGINIA AVE 2022-08-11 - Laserfiche WebLink

= PERMIT APPLICATION In BUILDING IIIECHANICAL/ PLUMBING /SIGN I 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 Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: )cia3 V, rsI'r.2 0lJ ivef t I 01/3 PROPERTY TAX#: 00 i '7 5'1.2441 CJ I A204) LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Ker i -fh -•- 140 I lY Zca- -i TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET /`1.1.3 /, ,rs js ,et. Ave gUef e 14- CITY STATE IA)4- ZIP / S2o' OWNER PHONE: `'/3.5--5 i2- ;27o1 OWNER EMAIL: ken_ Z b € I . U�-, r rn CONTRACTOR NAME: I+c,^+- c e fL✓lle-C 1 s el0 ; A S t-h ce-fek:f CONTRACTOR ADDRESS: STREET (-) /4 CITY (I A STATE n/.4 ZIP 11/A CONTRACTOR PHONE: \ I CONTRACTOR EMAIL: n/4 CONTRACTOR LICENSE#(REQUIRED): n/A CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): fl/A PRIMARY CONTACT: fii.OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: L1).5 5 1 2- 1701 Ken Z,r.6e-1 CONTACT EMAIL: ker1 „ Ze•-6e-i G I ,`fit:- . cot-) BUILDING INFORMATION Existing Use of Building: 9i•mefy 12-se5,dcr.ce_ L ERS Contract Price of Wo :$ 15 CC) Proposed Use of Building: Q c +MtAX./ 9-e-5, 4l cr>cc SR, Heat Source: ❑Ga ❑EI ( Other Pe.II-,} .5 Pc,.2i.- BUILDING USE: I:ISFR ❑Townhouse ❑Duplex ❑ADU El Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: El New ❑Addition ❑Remodel FiLRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Re.p tax c_ the- (c.vc+r Xi of t ►v5i) _1-( .\ �- Li , ✓� ii,tl ey.4-,cr•er^ wA-tk , kt-plcLcc i-hc I:.wzr (I, Of 0 ywe II fhry ,,,whale how:ac„ 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 A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) i Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless I Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain I. 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 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 Offici 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 comp/ ith the State Contractors Law 18.27 RCW and 296.200A WAC. • City of Everett Official Use Only PERMIT.# /x 1 fi n 70� Owner/Authorized Agent Signature Date (Revised 4/15/2019)