2805 19TH ST 2025-05-13 - Laserfiche WebLink

MiG4a n,`cAL ® 1•Ei"MIT APPLICATION isUILDINGOECHANICAL 0 PLUMBING /SIGN / INKLER/ DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov l www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION . PROJECT SITE ADDRESS: L'6 Oc 1 CC `�.\-- C-ve rt-1"'I" "�'e' PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) • CONTACT INFORMATION OWNER NAME: C:h r t.S#-1cw-J cc�Y,t;,,, c:- o:) TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 1( "5--- \ N 1.p.t4-c \-\c.,r-, 1)n_\'.R q �"' J `j CITY I_�ILt 5 -h✓ J vt' � STATE } ZIP Clcj(6 Z, . — OWNER PHONE: 4 75 1ST 04-/7c OWNER EMAIL: L5 f.Gc11‘1 rr-cwF'or's 0 1=M Cl i1, ,C�'1 r CONTRACTOR NAME: 0 t,..),-0 a Ni CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (ARC 1 Sl,0'-( S— C iryv 1 c-k-1 COrL;vc:'`Ct .? . CONTACT EMAIL: • BUILDING INFORMATION Existing Use of Building: `i f Q/ Contract Price of Work:$ 3S 000 Proposed Use of Building: (19....,r7(2 Heat Source: ❑Gas CI-Electric ❑Other r BUILDING USE: aBFR ❑Townhouse ODuplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition CRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: / 70-tf'2 -1-p nrc't c c- �s -I- ,re t-Ace- � � 1' P 4l,(J(t2re it-tic,Gian.'«-f 'ti rfit y<S ASSOCIATED BUILDING PERMIT#(if applicable): Pei Ac,fteellrtieize-it?if€4-Oren virp..0.4/rs MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) '' - Shower,Tub,or Combo Boiler i Gas Range ClothekWasher Sink-Commercial(3-comp,prep,floor) Clothes Dryer I Heat Pump&Ductless I Dishwasher I Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration \ Drinking Fountain a Sink-Utility,laundry,mop I Exhaust Fans(Residential) Commercial Ventilation t Floor Drain 'Z Toilet 1 Exhaust Hood(Type I) (Not Heat/AC system) Z Hose Bibb Urinal Exhaust Hood(Type II) 1 Water Heater Interceptor-Grease •.,y Waste/Water Piping Repair 1 Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas' Water Valves or Fixtures l bas Hreplacettnsert1L6g 5ce A t to j-0(p0 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.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# O/ '2L 11,0 r"Vt w 180l-Z,i) Owner/AuthYed/gent Signature Date (Revised 4/15/2019)