10725 19TH AVE SE B 2023-04-07 - Laserfiche WebLink

BUILDIN.MECHANICAL/ PLUMBING / SIG PRINKLER/ DEMOLITION E V E R E T T CITY OF EVERETT PERMIT SERVI PF 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: /o 7;2 S- //f" JQ i,' . U��V::, PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. a (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: /- 20c;,! 1Crrr 12(D 1 tc./i d r e_ L L CONTRACTOR ADDRESS: STREET U(.4 moo,i jgrn t,' c ) i'{ CITY Tll'Io,,, -`j,,' q STATE L1J 14 ZIP 9 i?(/-4 CONTRACTOR PHONE: `/2 5 'C I - -c: 7 CONTRACTOR EMAIL: di fo t,)J d/6 y w7 tr I . C.0 CONTRACTOR LICENSE#(REQUIR ): ji CITY OF EVERETT BUSINESS LICENSE#(REQUIRED PRIMARY CONTACT: ❑OWNER [CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: •�� 3��I • a /�' 7 � 1�SoN vJb7 CONTACT EMAIL: /,ref-0..v j j 1 6 i,,,t s. /. C.O‘^'•. J BUILDING INFORMATION /� ExistingUse of Building: Contract Price of Work: $ v v Proposed Use of Building: Heat Source: ❑Gas Electric DOther BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 1/i5/1// ,/^ i 4/'(rzt-5; ,t.t;( (t vitect 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) 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-Sand/Oil Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems f- Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log - Roof Drains Water Heater SPRINKLER/ SUP ESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads ACKNOWLEDGEMENT:I have reviewed this apr<ation 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# L i Pyv 9 -iv -- 2z- 6 k‹..... `-'1 0(1 — CO 3 Z