1616 72ND ST SE 2016-06-03 - Laserfiche WebLink

PERMIT APPLICATIOC /1j":4 BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION ,gCITY 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;!I.NFORMATION PRIGECT SITE ADDRESS: al ti) Si- JG EJle,(4� U-)1 PROPERTY TAX#: DOS 3 G 1 ob, 60 (P O0 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ONTABT INF'ORIV�ATIO - ` " ' OWNER NAME: y1la, •kt.e,1/4_1/4.) L I©'1 ),V1ScJl) TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET i(p I (p -42,"44 S . 5 E. a CITY ��V�f STATE w ZIP 1 O n.6 3 OWNER PHONE: 2_062- 9 02674- OWNER EMAIL: morike� wvtericLi �$3 i)3nietA • t'..�1�✓1 CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET are STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: lig OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206,. q3 02-q4/1 e.AA/ -17-bl Y1:5 ✓1 CONTACT EMAIL: m o'kE L.'L ir?l/ (� 1 g 7 fi i1GZ.1 1 • BUILDING,PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: S -I2 Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: GQN5r2UG-T 409 S.F: cK -rAiF5 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION` . . PLUMBING':PERMIT.APPLICATION Type of Project: _New _ Addn _Alteration Reps" Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of Lis f Fixtures #of List of Fixtures #of List of Fixt es Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units eat Pump Toilet Backflow Prey: er(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drink'.• Fountain Water Heater Refrigeration Shower F o or Drain Gas Fireplace ` Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer ookups Other: Clothes Washer Medical Gas Range Hoo Water Heater Other: Exhayst Fan Sink(Service/Ba op/etc.) Other: RINKLERP.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.I am 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. City of Everett Official Use Only / PERMIT Own• thorize. gen *r"�ure Date (Revised 10 2/2015) ‘i