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

., l,_:_:_.-: _.::� GEC. i,,VFFIC I:AC PG..pCATC�.• ,,,, BUILDING / ��I1Ec C�sF�iUCCsf°�lL. / PLUMB IN � / SIGNI SPRINKLER D 611e� CC"li"C�AE� E CITY OF EVEREl'PERMIT SERVICES f r'lm'/n 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 (I3kiie or :,lack Ink Only Please) !PROJECT SITE INFORMATION __ PROJECT SITE ADDRESS:/Di 2-,3 C. /9 '7 / 67. cf. 6 PROPERTY TAX#: Zg 4.1"1 Z,o31-0 ► LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) I TT� CONTACT INFORMATION _�� J I OWNER NAME: f # V( , t3-/j) ¢ 71* WOO OO TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /b3D q J A" 7!h J74 eel, CITY y�+Li..ov v e- STATE* i"..... A' ZIP p g 0(�1' OWNER PHONE: OWNER EMAIL: f t et et q (V,v7 1,...a vw1/4.) �p pug i 4` f. c,, CONTRACTOR NAME: 7 �l _�, I CONTRACTOR ADDRESS: STREET I CITY STATE ZIP 1 I CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): i PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 9THER(Please Specify) A- 7—C.- -( ( T .t'�' CONTACT NAME: p—' 'r Lr-Ar stes.sit,,.i CONTACT PHONE: C4..v) 25Z - '2 I J 3 1--e,pa A(L cil g -TiZ-C7 up... ..--. CONTACT EMAIL: r ASS BUILDING PERMIT APPLICATION Existing Use - kl the wN M o N Proposed e of Building: T o e' Heat Source: ❑Gas 0 Electric DOther Building Type: EISFR-Detached 1'•NFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: El New DAddition DRemodel ❑Repair DT.I. OSign DSprinkler CI Demolition El Change of Use DESCRIPTION OF WORK: P Ptu(' '.5I`17_ I2 vAJ IT T o...-- N H , vS' Con e Lt.T x., w( (t n t v 1 n v 44_. r e--a r -t t--ne i it. (z -c_.J-i v N c. ASSOCIATED BUILDING PERMIT#(if applicable): 6i 3 a i.12 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 Pump Z. Toilet Backflow Preventer(Inside Bldg) Forced Air Systems r Unit Heater i 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 Other` I Clothes Washer Medical Gas / +Range Hood 1 Water Heater Other: L3 Exhaust Fan .. Sink(Service/Bar/Mop/etc.) Other: SPRINKLER I SUPPRESSION SYSTEM Chemical or Water ➢ —INo. 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/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 i PERMIT# Owner/Aut orized Agent Signatu 0 Date (Revised 9/23/2096) 1. Z