10917 10TH DR SE 2016-06-01 - Laserfiche WebLink

PERMIT APPLICATIC"' 477- BUILDI� MECHANICAL I PLUMBING I SIGH iPRINKLER I DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: doi 1 3- I D. y . PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) G CONTACT INFORMATION OWNER NAME: ‘..1612.0.414-NI JONES TENANT NAME (If Commercial): OWNER MAILING ADDRESS: STREET \00 I-1- 101A ?'� v0 •rr 7 yv k ZIP 782,08 OWNER PHONE: 442- 3347. k 3q4 OWNER EMAIL: CONTRACTOR NAME: SQe-ciP1L. I �V NI p 1,1fj/V B(ivC? I (n(-C, CONTRACTOR ADDRESS: STREET 2: 5t,s� tk G�( { CIT ilja �Y rL(i ..F��_ VVZIP 9'63 96 �r./72- CONTRACTOR PHONE: SCIOi37-.92_42 CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): C sNclvvoi o5 3\ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):Qt (-('�� PRIMARY CONTACT: ❑ OWNER ip CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: )01-IN 010.(4041-• CONTACT PHONE: 4/S35 CONTACT EMAIL: Jb1aNVJe 'ft AALPI. 5eg..1eEc BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ONew ❑Addition El Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: MAA) WO-filth rvi_ suktoq --a re,c00.1a9 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn Alteration _Repair Type of Project: New Addn _Alteration Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) 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 Water Heater Other: LA:AtcI2r line Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER / SUPPRESSION SYSTEM Number 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.lam the owner,or lam 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 or' .�e 3 24�� PERMIT#0` (06__®1,r. Owner/Autho d Ag• t SignatiTf'e A Dot- (Revised 10/12/2015) t