10723 19TH AVE SE B 2023-04-07 - Laserfiche WebLink

= CATIO ' BUILDII�MECHANICAL 1 RP PERMITUMBINGAPPLI/SIG 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: /07 L / 3 /9 �� L 3"f. 4© PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: A R/v j cc ZQ(-2vf'ei TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 01 0,) r,`At. i'C f c 1-1%),- CONTRACTOR ADDRESS: STREET /'7/' f'Y W l 4/'", ( ' k O f r CITY (12 0,, STATE L)IA ZIP ISM(/2 L CONTRACTOR PHONE: Ll,S- 3o/- c5 7U-7 CONTRACTOR EMAIL: iti('re,,,JJ cI/6413 m m.)•Ca o--- CONTRACTOR LICENSE#(REQUIRED): j'1( Co.,/ F r�ii Pk CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): b 0 Z 3 L PRIMARY CONTACT: ❑OWNER ( -CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: _ Ll)5 -3,l 370 I J 1;150 N b CONTACT EMAIL: [7 1 14 f ry,J J tl/ b u)- wi•,;l . C O.,•,— BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ `7 OO Proposed Use of Building: Heat Source: ❑Gas ❑Electric DOther BUILDING USE: ❑SFR ❑Townhouse El Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: I (New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign EISprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: h cI/( V,�� ,.C,0 -f i'rc;S InS,4// c,,� pro4lci a vie,`+ B (ic It) ASSOCIATED BUILDING PERMIT#(if applicable): / Cl��3-�� 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 Ventilatior 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 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 /Li 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 1 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# 1 ' ----...--7 Z-•"/. .."----- / -/ -Zo/ � l, (C - 0 ---7 Owner/Authorize; nt Signatu Date (Revised 4/15/2019} /Z