10719 19TH AVE SE B 2023-04-07 - Laserfiche WebLink

...''1/ 0 py,R,,,,,-,/3,APP LIGATION,. - 4e FUMING I iEC.1--0ANQCAL I PUN/BING I SIGN I SPRINKLER/ DERI OLMON tii CI IY OF EVERET-I 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 [(Flans or [=lack Ink Only Please) IPRoJECT SITE INFORMATION -- --- PROJECT SITE ADDRESS: /a,// 15 /9 /47 4-1.--6--. cr, j PROPERTY TAX#: 2Q Dr"2,61 7o3 4c LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION- —OWNER NAME: kefiV4 / v/A.f ¢ 7jeV 1 1,4/00 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /630 q J F' 7 i c/7 1 ee- . CITY S.a LL/' /.v e STATES IA,. A- ZIP pg 0 O OWNER PHONE: ' OWNER EMAIL: t L c1 e( q (V 8 rv? 1,0 v vI:.) kI l, C,,,4y CONTRACTOR NAME: T „17, CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: El OWNER 0 CONTRACTOR (I-OTHER(Please Specify) /1-77.G.I-4 (' Tc,-ci-T CONTACT NAME: tZvss' L—A-,reteS alk...4 CONTACT PHONE: C44-Z"59 Z S'L. - '2. I J 3 1-2. An-cf'tl -Ter C:T cep - CONTACT EMAIL: r'•SS Q.. 1l 2Ci r- .'j-c..cj c. '-I- .C,6r•1 BUILDING PERMIT APPLICATION Existing Use of Building: S [it-1 I-e ire--f'r el-e.pa e. t_ - Contract Price of Work:$ , Proposed Use of Building: r o e" Heat Source: ❑Gas 0 Electric ❑Other Building Type: ❑SFR-Detached FR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition El Remodel El Repair ❑T.I. El Sign ❑Sprinkler El Demolition El Change of Use DESCRIPTION OF WORK: rit V i 0 i €S . 1 2- v AM'T' T O w hi ♦l D is g 1c-- C.a et f' L,4.11 )(, LA--/ 1 N h< L'! n v 4-t_ r t-a M l`r.J rt. 1t- v N L T ASSOCIATED BUILDING PERMIT#(if applicable): ef,,, - - 2-, MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New — Addn Alteration Repair Type of Project: New _Addn Alteration Repair #of List of Fixtures #of List of Fixtures #°f List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump 2. Toilet Backflow Preventer(Inside Bldg) Forced Air Systems / Unit Heater ( Bathtub Urinal Gas Piping Boiler 2.. Lavatory(Wash Basin) Drinking Fountain Water Heater • Refrigeration I Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range ; Ducting Dishwasher Roof Drains / Clothes Dryer Hookups Others I, Clothes Washer Medical Gas / Range Hood I Water Heater Other: 3 Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER I 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 PERMIT# (6 Owner/Aut orized Agent Signatu'e _ /��Date (Revised 9/23/2016) ,..„.....__(\.j 4::Z.-4 ——