8810 EMERSON PL 2023-09-26 - Laserfiche WebLink

IINIMI PERMIT APPLICATIO BUILDINECHANICAL/ PLUMBING /SIGN t PRINKLER/ 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:e0 -tV1-001 PROPERTY TAX#:oo4 -zc f oir) - LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT.INFORMATION OWNER NAME: /i.�° f\ jp 1?i, 4 ! j TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET p*, i rj ', Jail L°(, "---, CITY FL 'I Vr - STATE 1444 ZIP 7 k° OWNER PHONE: (OWNER EMAIL: ---- - ___ CONTRACTOR NAME: --1(-//1Ibr ( °-a�/I l r )., CONTRACTOR ADDRESS: SJREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ''.OTHER(Please Specify) -,In / �"" CONTACT NAME: CONTACT PHONE: �%(ts 4 Cc 1 �,G �'i c'er \f 'P CONTACT EMAIL: @ 1� JJJ///��/// 0,� .t ( ''''"'LA BUILDING INFORMATION Existing Use of Building: 7 g Contract Price of Work:$ .J Proposed Use of Building: � � Heat Source: ❑Gas lectric ❑Other BUILDING USE: SFR ❑Townhouse El Duplex ❑ADU ❑Multi-Family-#Units: / ❑Commercial ❑Accessary Structure Type of Projetf. ❑New ❑Addition Remodel El Repair ❑T.I. OSign ❑Sprinkler ODemolition ❑Change of Use DESCRIPTION OF WORK: / Pam.,IA ►-i—f c.-La- CS C, 1 ii lit' ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION:: PLUMBING PERMIT APPLICATION Fixture Fixture Fi ure Fixture Count List of Fixtures Count List of Fixtures aunt List of Fixtures Count List of Fixtu s NC—Air Handling Units Gas Piping . p V Backflow Preventer(Inside Bldg) I Shower,Tub,or Combo \, Boiler Gas Range / 9 Clothes Washer Sink-Commercial(3-comp,Orep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bhth,bar) Duct System(Remodel) Refrigeration I Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Vent'ation Floor Drain I Toilet Exhaust Hood(Type I) (Not Heat/AC sys em) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Pipin9'f2epair Exhaust Hood(Residential) Wood Stove \ Interceptor-Sand/Oil Water Service(bAind meter) Forced Air Systems Other: \ Medical Gas Water Valves4 Fixtures Gas Fireplace/Insert/Log \ Roof Drains Water Heteer SPRINKLER I SUPPRESSION SYSTEM. , Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads `. - `` ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true any fiyl,ci.t. ...,.....one 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.lam 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. .-.a..____ Use Only City of Everett Official Owner/Authorized Agent Signature Date (Revised 4/15/2019)