410 51ST ST SW 2016-06-03 - Laserfiche WebLink

APPLICATION 1 LT-- BUILDING ECHANICALPERMIT/ PLUMBING / SIGN 'RINKLER/ DEMOLITION O CITY OF EVERETT PERMIT SERVICIS 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.SlT DQ/043 :9 L) S V St 5 U PROPERTY TAX#: 2—IW 1-13(v OD i O 3 )- OO LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) v l J CONTACT INFORMATION OWNER NAME: I t o.1 p r%e, 1.-w axirt TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET/{`U C14- c)`r (:--) l.t./ CRY E4 Ql.'''ejk. STATE ZIP el -1--v 3 OWNER PHONE: 14 2c 9 �, ' ( OWNER EMAIL: CONTRACTOR NAME: S{P f-(5 PI %.,Le ,b LL( (...-- CONTRACTOR r CONTRACTOR ADDRESS: sTREEr�-.,)—5 1,-)0, STATE n _l% ,Sc d /1 CITY L h V> l�fb STATE V J A- rp 1 'O3(c. L CONTRACTOR PHONE: LI L, 77 OLIO CONTRACTOR EMAIL:c&J✓ P( Arl\b;�U _. (�n/1(�p�j�{',NST CONTRACTOR LICENSE#REQUIRED: CITY OF EVERETT BUSINESS LICENSE :O c )�T�VE P .�� ( CMZ, Es f�ftEQUIRED,. N93G I PRIMARY CONTACT:/ 0 OWNER 14 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME/I /� ,�/ (� �/� CONTACT PHONE: 1.-1),c 21 g .2,0 S-O o ! t �V1:,1 )© \v ' \ CONTACT EMAIL:}(LV LS 9i,wtv1 b,-- 1 G(O(M� -(,D✓� < 1 BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 10 Un Proposed Use of Building: Heat Source: I6Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel A'Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: R • .e_p 10,1,-(, d\ J o�. ,,S (1 A i- A-0 F,t-n,,i,e._ Go istiA r ve c,l ve..s 11‘0,e r ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICA1 PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration I Repair Type of Project: _New _Addn _Alteration Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal 1 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 I.,-:1 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,:•g 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 1 comply with the •ate Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 64 Zz �, 03-641 Owner/Authorized Agent Sign a Date (Revised 10/12/2015) C