|
---,, —.'...._,
<br /> '---
<br /> " ' '_'.'.:-.`k ,- '•-, ,
<br /> SIMI PERMIT APPLICATION
<br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION
<br /> CI CY OF EVERETT PERMIT SERVICES
<br /> ' k EV RETT 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 I FAX 425-257-885/ I(E)everalteps tieveroltwa,gov j www.evetettwaigovipermais
<br /> Aiit1M':" :oak Ink Only Moan.) PROJECT SITE INFORMATION
<br /> 1 ,,,, _,,,,,•,
<br /> ,ADDRESS:10521 19th AVentle SE,Suite 100 PROPERTY TAX#:280520-002-030-00
<br /> '•• '•••,. $.: - , ,r rezn Shed PtatNuildtvistort Lot Ne, (attach copy of long l'gal description)
<br /> . '"-
<br /> CONTACT INFORMATION
<br /> .,,
<br /> OWNER NAME: Kin Wa Chan New Leaf Pho
<br /> TENANT BUSINESS NAME teorrat.erciaty
<br /> OWNER MAILING ADDRESS: Fs't4f(r 1432 173rd Street SW
<br /> Cif"( Lynnwood 6/ATE WA „hp 98037
<br /> .., ,
<br /> -.. ,.,0 E.,:360-990,-0836 OWNER EMAIL;bluowliatechamtsal@gmall.corn
<br /> CONTRACTOR NAME:Kin Wa Chan ---
<br /> CONTRACTOR ADDRESS: STREET 1432 173rd ST SW _____
<br /> • 98037,,
<br /> r„,,, Lynnwood STA1E WA „
<br /> CONTRACTOR PHONE:360-990-)836 CONTRACTOR EMAIL:bitiewhaleCtleMiCal@gfrail.00111
<br /> ., LICENSE INREatAREDy BLUEWWC823P 9 CITY OF EVERETT BUSINESS LICEbISE#fREQUIR : _IS 41
<br /> ,..., ___.....
<br /> DOWNER LI CON INACTOR 0 OTHER(Please Specify) TLS Consulting_Enginears
<br /> coNTAOT k,',",
<br /> CONTACT PHONE206-853-5728
<br /> •- '
<br /> QuyerfNguyen CONTACT EMAIL:quyenseattle@gmail.com '
<br /> BUILDING INFORMATION
<br /> '
<br /> Exicting Use of Badding:Mixed Use Contract Price of Work:$70000
<br /> Proposed Use of Sulklir,g;Business Heat Source, 3Gas CIElectric 00ther
<br /> BUILDING USE: OSER CITownhotise DDuplex LIADU DMulti-Famity-#Units: (71Commercial DAccessory Structure
<br /> Type of Project: Dr fliwctition ORereodel DRepair Ott []Sign OSprinkler Dflemotition EIChange of Use
<br /> DESCRIFTION OF WORK.
<br /> .. Tenant improvement for a restaurant. No structural work.
<br /> .„.
<br /> ASSOCIATED BUILDING PERMIT#(If aulicalNej: 111,703-f)24
<br /> -!#,:',:i':::: ‘,'• hr ICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION
<br /> A:oiowifi:ov k ---,1-... Froas ; ,, Fixturo f Fixture
<br /> ... coiia .....' _.,,g,n Fixtures Oa OI rixOrres List of Fixtures ' List of Fixtures
<br /> C0444 COW), Count
<br /> Ga
<br /> , • 4 rtglal Linea ,.... I Pip(
<br /> C a. ng Backftow Preventer(Inside Bldg) ,Shower,Tub,or Cotrixt,
<br /> ....Gas Ramie .7-> Clothes Washer "/.. SInk-Coognercial(3--Comp,wep,ftoor)
<br /> ,
<br /> 4,Ree( . Ductless IbUthwasher Sink-Residentlet°Oche n,bath,ban
<br /> _t,.'2 - (Remodel) ration .
<br /> Dfallong Feu;gain Sink-Utility,laundry,mop
<br /> s(Residential) ' Cot' /cat Ventriallor- 4..,k. Floor Drain ,, ., . Toilet
<br /> opoti(Type I) ( , al/AC system) Hose Bibb Urinal
<br /> `71100.1(Toe It) '‘•,( .Watertfeetet InterceptorDrease Waste/Water Piping Repair
<br /> 4• , tst KoOd(Resideminq Woottitove Intercepter-Se ndr0 il
<br /> --
<br /> ..,,00, ---, .. ____,,- Medical Gas ,Water Service(behind mete;)
<br /> Forced AfiSystems \,4 Water Valves or Fixtures
<br /> Fireplace/Insert/Lc* - Root Drains ,,i• Water Heater
<br /> R i SUPPRESSION SYSTEM Sewage Elector or Sump Pump i ' Ni
<br /> •? r '""" ''''''''' . , • Other:
<br /> -.1"..':'!:t- j1::Illiali:f`''' , '''''' . m I 116'. ''''':':.' „ —
<br /> No,...,% •: —
<br /> I
<br /> -\\.,
<br /> ,
<br /> lig •,'4,, „$..' $,,,,,5,$,!,:5.5''.;5,'ithaW 150415105V,Vdpilgippkanbn' '' the infwmitibn contained;wok is inn,and correct work dom pursuant f
<br /> e
<br /> ints
<br /> perm must commt with
<br /> C )2 eel kw.,Th.e ORONO f a ' euthorizos approved worn one The ti evielput therefrom.Doviotions must first be authorized ii
<br /> :'.:40-* ' ' '•0$1Nftr , ',- ,ote0ortittfttlreekit'Ate i
<br /> $1•6•;,,,,,.,:,,Aosi$,,,- , ,,, ,ci, .., , ,i7.--. iv ._, on tho owner,Ott orn entWedtlitd, ,p, *Owlet 01 this own)/10 porfonn itict work yof whxitihwanppingicafmntior:Lijemadc„..
<br /> ttt.4,,:;:077',,, :,,<„; ,,,,:t• !Pm golre 1427 MI*"0#0 1 21Iitt*VOA WAC
<br /> ',5§ '" •°''L A'''1 lki - -,• ,- • i*- ,',,,,,
<br /> ..--..,-, -', , 1 ,t, ' City of Everett Official Use Only
<br /> 1, .'••13..'':',' . $555, *--'.'T-,
<br /> W5?'V':P g•'.„, '': 1'11-<-5-, ' ' '
<br /> PCRMIT 0 $
<br /> '''' • sat,;. „ 77„•••,.. ,„
<br /> 1 al
<br /> Ownertitufnutfron Aount s_qrjosttuo Date . ..
<br /> (Revised fOifor20110"
<br /> - -,-T .-- ,,,,,eie,
<br />
|