2405 MAPLE ST B 2023-06-21 - Laserfiche WebLink

= PERMIT APPLICATIO BUILDING ECHANICAL/ PLUMBING I SIGN RINKLER I 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: P(06 M \l, `�. CA- , - /t cit. PROPERTY TAX#: L(O 72 d If o 9 JDO _ LEGAL for new construction: Short Plat/subdivision Lot No. (attach copyof long legal description) ) CONTACT INFORMATION OWNER NAME: 1)i.h.,,iiuk, -To i,lasotv TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET {02 � 7 O / 1-'V2, S u) CITY .S- CkA-`e. STATE Wit-- ZIP 6 14f 6 I OWNER PHONE: 7-06 (7 - 6'3 n OWNER EMAIL: we AAj Z_ e). 42 hei-i- l( ( ( r (4 CONTRACTOR NAME:• l`,,VL N SC (5 J4-o(Vk S a- CONTRACTOR ADDRESS: STREET '' iD 1 &) 7 t ( J CITYV-\tV4 A AJ STATE PA ZIP 1(g O'?3 CONTRACTOR PHONE: iZ.. '� � 36 CONTRACTOR EMAIL: 4 G CONTRACTOR LICENSE#(REQUIRED): Lam — 611 �3 ", CITY OF EVERETT BUSINESS LICENSE#(RE'QJIRED): S.73 PRIMARY CONTACT: 0 OWNER C✓-CCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: j:EZ�-1 .�' 6-3��j Mt clitkti 5M CONTACT EMAIL: Q c if-ilii ( (, 67 0 . BUILDING INFORMATION • Existing Use of Building: N Al, Contract Price of Work:$ Oi©€O r DO r�/ Proposed Use of Building: k`kte. lA-b v Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex thADU ❑Multi-Family-#Units: OCommercial ❑Accessory Structure Type of Project: El New ❑Addition El Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler 0 Demolition ❑Change of Use DESCRIPTION OF WORK: v\5*d. 3 AA,ac-Iftetitt'Lc1'4r -ct 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 List of Fixtures Count NC—Air Handling Units t i Gas Piping Backflo Preventer(Inside Bldg) ( Shower,Tub,or Combo Boiler Gas Range l Clothes Washer Sink-Commercial(3-comp,prep,floor) I Clothes Dryer Heat Pump&Ductless 1 Dishwasher 3 Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop 7j Exhaust Fans(Residential) Commercial Ventilatior Floor Drain ( Toilet Exhaust Hood(Type I) (Not Heat/AC system) .) Hose Bibb Urinal Exhaust Hood(Type II) 1 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 1 Water Heater SPRINKLER/SUPPRESSION SYSTEM. Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads y 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 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. 1 City of Everett Official Use Only / � ;/ �',_ `, PERMIT# •..i,l � - 2-72 00 Owner/Authorized Agent Signature Date (Revised 4/15/2019)