2715 12TH ST 2016-06-01 - Laserfiche WebLink

41:77- PERMIT APPLICATION BUILDIN A i MECHANICAL 1 PLUMBING /SIGN INKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE_INFORMATION PROJECT ydFVtr Q'; –�'Xi \a•"` cA• PROPERTY TAX#:�c�Q �� +�r� QQ LEGAL for new construction: Short Plat/subdivision Lot No. I (attach copy of long legal description) . ;_ 9. _: - .:. CONTACT INFORNf010N:' , • . OWNER NAME:E\iese, \\ou -,,, NAN, 'Xi TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET•b , \ `-V1 cnv VE?«'t'I STATE W C_ LP9 ? ©(c A OWNER PHONE: OWNER EMAIL: CONTRACTOR NAMEr 4V��r -‘1,1\.. O� CONTRACTOR ADDRESS: STREET�'�C))C: KOQe ii,, cITY`j Q.y---‘ STATE \::3- ZIP Ci gSR CONTRACTOR PHONE:1.-G5"0\ 1 U CONTRACTOR EMAIL: ('S t �•s\AI-N C OL,Q`+CZ SYS,, CONTRACTOR LICENSE#(REQUIRED): (Q©r~`p "�-904-A CITY OF EVERETT BUSINESS LICENSE#(#(REQUIRED):dzascg0 PRIMARY CONTACT: 0 OWNER fsft?ONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Lirq., -2.\ -ec f L) -o\i-vc\ W k\\'Q\ S CONTACT EMAIL: v.P` \.\(\ --`y�� O ;: BUILDINGPERMIT APPLICATION =:: Existing Use of Building: YYV'1A.W\–N-0otYzA4' Contract Price of Work:$ .-1)50 •— Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex 1MMulti-Family-#of Units: 4 ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel2epair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use D SCRIPTION OF WORK: %,..•r, . pe c :�.. - -•t`.=•. ri 'err to `� �. .� � ��! :' 02 c mer .e.:i.x stAN \ \o s- S-A-el')- 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: 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 B 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, a d l co ply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only • "1s 1 I( PERMIT#b ( V© Ir v I V/ uthorized •gent Tr a re Date (Revised 10/12/2015) ‘I ,J