3421 TULALIP AVE 2025-11-03 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING/ SIGN 1 SPRINKLER/ DEMOLITION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (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 INFORMATIONil- PROJECT SITE ADDRESS: ,_3 z_ TU��1 / =•��c' V�/�� Vt�/1 PROPERTY TAX#:Sa-1r7 e, LEGAL for new construction: Short Plattsubdivision —! Lot No. (attach copy of long legal description) --- CONTACT INFORMATION OWNER NAME: . Z✓/ le 5 C . Mo TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET l 6 I �r �r7�e 717 4' ,/ CITY �t� I Ve ��k7 STATE wl-4 ZIP 7C/ OWNER PHONE: -?&0 .5 -/U '5 7 f S OWNER EMAIL: cv l /( S (.ter PS -e rn C' 6-,,1 j r CONTRACTOR NAME: CONTRACTOR ADDRESS: ;�sTREEr CITY STATE ZIP CONTRACTOR PHONE: NIA CONTRACTOR EMAIL: t,114 CONTRACTOR LICENSE#(REQUIRED): N ;'t CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): — PRIMARY CONTACT: OWNER ❑CONTRACTOR ❑OTHER(Please Specify) — CONTACT NAME: M J N/i C S CONTACT PHONE: .S ,LI 1 c 7 7� CONTACT EMAIL: 6U;• /Q S GLrP S //► 61 BUILDING INFORMATION Existing Use of Building: ✓��C' %LC 0 u S C✓ Contract Price of Work:$ /0 0, 00 0 , ', Proposed Use of Building: s/n um/ i c x?✓ Heat Source: OGas ❑Electric ❑Other BUILDING USE: I)SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition RgRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: genove0e {Torn ASSOCIATED BUILDING PERMIT# if applicable): C W / 7 19 U fJ w l ! 0 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 3 Gas Piping C> Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range 2 Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher `3 Sink-Residential(kitchen,bath,bar) ` Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop 3 Exhaust Fans(Residential) Commercial Ventilatior Floor Drain ' Toilet Exhaust Hood(Type 1) L� (Not Heat/AC system) _ Hose Bibb Urinal Exhaust Hood(Type 11) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) 0 Wood Stove U Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: l Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log C_) 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 PE7 # Owner/Authori re Date (Revised 1011012018)