2939 COLBY AVE EVERETT MUSEUM 2023-09-26

PERMIT APPLICATION S BUILDING/MECHANICAL/ PLUMBING /SIGN/SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 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 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: Z O 3 CC) 1i 1 y /9-Ve PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: / OWNER EMAIL: C.CONTRACTOR NAME In s€m pi U�.b>7:3 L L -. — �- 4. 4 t i 1M i.. b i CONTRACTOR ADDRESS: STREET PP r i e) �L t/ CITY S fee i 1.100,A. STATE L/A ZIP 9 CONTRACTOR PHONE: `IZ S- 32.7-LOf'/(./ CONTRACTOR EMAIL: 00.. /Jl„ncoo piLnh.%?,)fr , ccAn CONTRACTOR LICENSE#(REQUIRED): GN p L U f L'LU ,J a CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6 °2 PRIMARY CONTACT: (fgOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: `i z s,_ 3 Z7_2 0 o/y Not-3--6 et /4phf-en CONTACT EMAIL: No,+cA) BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ CZ$ Oc.? . c o Proposed Use of Building: Gvc,eh M L-Seu c r! ?s-tw y Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: 114Commercial El Industrial Type of Project: ❑New ❑Addition G ..Remodel ❑Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: rk z My v� ��3a, p1 v.bi^' 12..ad 61, ''/`/ '014,+1- sli-4 i/ A ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn �C Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump 3 Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler 61 Lavatory(Wash Basin) I Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood I Water Heater Other: Exhaust Fan 3 Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water 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 properly to perform the work for which application is made, and I corn ly with the S to Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only I�/,IlI ® � /n� r) ( 0 I PERM � (Zt» � 1 /l//L,/1h✓ wner/Authorized Agent Signature Date (Revised 9/23/2016)