2602 81ST PL SE 2022-10-07 - Laserfiche WebLink

PERMIT APPLICATIOit tri BUILDIN MECHANICAL/ PLUMBING /SIGN / PRINKLER/ 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: '662 , /S/ /3/ SI f x,,-C// PROPERTY TAX#:00 6 9//0000 2/0e7 LEGAL for new construction: Short Plat/subdivision Ur .9}� 2 C�3 Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: ea/iM 4 thRd Er/J6),h .4 lea it-/1 et-- TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET Z 6 02 1br/rf P/ _C �/ n ,�J �v q aCITY rVe IZL /7 STATE VY �/ ZIP grg�/i OWNER PHONE: p 0/(� %/73 yZ OWNER EMAIL: wetr/1 erg /=, I a9Qe C' 4/7-1 CONTRACTOR NAME: , /te*H d w /`d L/C CONTRACTOR ADDRESS: STREET 7 7 IY, 5 7 i //Pe L CITY FI/e/e< / STATE ✓v /O ZIP 20S CONTRACTOR PHONE: 2-5-7f 51r rC CONTRACTOR EMAIL: daffy. -C7LeG/1 GY /d AG,2'/L c r CONTRACTOR LICENSE#(REQUIRED): if///?�. �.`p t��j 2 6 U.S.' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) Q' , PRIMARY CONTACT: OWNER 0 (Please CONTRACTOR 0OTHER Specify) CONTACT CONTACT NAME: CONTACT PHONE: re)/ '977 '2 ti/%, CONTACT EMAIL: BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ I 6'V c'F� Proposed Use of¢uilding: Heat Source: ❑Gas V lectric /■Other BUILDING USE: Vil SFR ❑Townhouse Ct❑Duplex DADU ❑Multi-Family-#Units: ❑t•is. =rcial DAccessory Structure YJ Type of Project: DNew DAddition Remodel DRepair DTI. ❑Sign ❑Sprinkler ❑Demolition OChange of Use DESCRIPTION OF WORK: l ei// c/mac,/, ;c �u/1fG'�L� a rid' �u� �(,.._ 1 ASSOCIATED BUILDING PERMIT#(if applicable)W ` ` r'DO 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) 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 IExhaust Hood(Residential) Wood S ve Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems her: -Id e li-r Medical Gas Water Valves or Fixtures iGas Fireplace/Insert/Log /'b/t/ do'H rJiLi / Roof Drains Water Heater SPRINKLER l SUPPRESSION S STEM 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. r - 1City of Everett Official Use Only 2• . 2Ofb P T� � 1)r` 1 Owner/Authorized Agent Signature Date (Revised 4/15/2019)