3006 15TH ST 2025-04-07 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES OL 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 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: PROPERTY TAX#: J J4->5f 7 51*1d Ald LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: mihCiIi, TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET ,?U '9 Fk CITY `5 �l ' STATE ZIP OWNER PHONE: ,Z s) �j� �- 116 OWNER EMAIL: 5 r �r aaa4�111 G v CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT:&OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 5 IJUI;1 IM i �j V1' LA I' CONTACT EMAIL: BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: e.-5 t'J e yk is I Heat Source: ❑Gas Alectric ❑Other BUILDING USE: ❑SFR ❑Townhouse Ruplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Chan a of Use DESCRIPTION OF WORK, f, uke w►i,nvr �� yt~s to �I0�c�sk� ;{s , . c�� (A �� ,:c; ('t&Lk LkIn c+ Mc ue sowte P� act V(�e s. i a a i` c G tf e s I �i �3a►'�� t tti ASSOCIATED BUILDING PERMIT#(if applicable): I we✓e I (! 1Kj MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures List of Fixtures Count A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type 1) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type 11) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/ 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 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.1 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. PERMIT# City of Everett Official Use Only ;, / — _ �jl •�� Owner/Authorized Agent Signature Date (Revised 1011012018)