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

BUILDIN ECHANICAL / PLUMBING / SIG�PRINKLER / DEMOLITION 32 EVERETT CITY OF EVERETT PERMIT SERVI 00 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 0 7,2� /9/.. Ii / c j y Vrt _PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. ' (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: )f4)r1 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: A 1' ,_ ,, f-i^ ' -eel j,,l i^_�L CONTRACTOR ADDRESS: STREET ID 7 F. ",i,,i-.,,,...V'r'c,„} t vim_ CITY I 1 /t'/9,5 4 Ul/ .' STATE G L.., . - ZIP `-) Z CONTRACTOR PHONE: t/o :3o/- --7o ') CONTRACTOR EMAIL: 1Q(re)64jd/(,Gt /0-7�r./, CCU I, CONTRACTOR LICENSE#(REQUIRED): (i'` 2 D Li 07 g Ll 1 Pk CITY OF EVERETT BUSINESS LICENSE#(REQUIRE - PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: -/ 2 5 - ;, • CONTACT EMAIL: ei rro,,,fj 1//.ce j,Li- �ul. CG►^ BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $ L Q 0 Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other 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: ..f/'15/(4// /`i nxL 5112103/ !i b.' i A ''1 %i jr/, L/ fr S Gr /C `i 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 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/ SUPPhESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads ACKNOWLEDGEMENT. I have revie�ed 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. Th€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 c PERM IX#(.:-::' c • Q r / /o - z�l l k . < l OO"A