3001 BELMONTE LN 2016-07-28 - Laserfiche WebLink

PERMIT APPLICATIO BUILDIN_CHANICAL/ PLUMBING/SIGN I WINKLER/DEMOLITION 1!!!!!!!!laCITY OF EVERETT PERMIT SERVI ' y 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 ((E)everetteps@everettwa.gov www.everettwa.gov/permits " g' PROJECT EttO10 F # ATIO+1, ., , T s 6 c i O x fi , E,M PROJECT SITE ADDRESS: 001 izeiwl 01+e /4 vt e PROPERTY TAX#: 0 0 e r oZ (yo LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) OWNER NAME: K'uku+4.e S TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3t Pym I 1. 1,.,z. CITY go STATE Oh ZIP 'ado 0 I OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: A 0,A1;-L, pL� Lr '17G. CONTRACTOR ADDRESS: STREET f1'4 6 I u ke_ h(. CITY t kL STCIfGhs STATE ijA ZIP .1805- g CONTRACTOR PHONE: to j g70- 7 si' ' 1 CONTRACTOR EMAIL: se r us C�l� ,v� ,vr b; CONTRACTOR LICENSE#(REQUIRED) Q(A4kr p$7) G_ CITY OF EVERETT BUSINESS LICENSE#(REQUIRA): '/3 PRIMARY CONTACT: ❑OWNER 9#ONTRACTOR 0 OTHER(Please Specify) CONTACT /NAME: CONTACT PHONE: LI - t ?c- ? S' 1 (77 t v e_S`"10 V1 CONTACT EMAIL: S e i- ;Le,p P I v.,nti b:n td A. cowl Existing Use of Building: �;n l.e_ I e r �y Contract Price of Work:$ 11300 Proposed Use of Building:, IWC! Heat Source: 1 as ❑Electric ❑Other Building Type: ❑SFR-Detached ESFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: El New ❑Addition GI Remodel Repair ❑T.I. ❑Sign ❑Sprinkler CI Demolition ❑Change of Use DESCRIPTION OF WORK: 1��,� 1►�-vv�ax,S 1'. o r7e.4. 1� Nf7 i D vt its pace, 4.0 40-1-_ 4044 S 4c-e A": KG, , ASSOCIATED BUILDING PERMIT#(if applicable): r -a ) 6 `4 r t u t t 4 z ;:'�..,*E,OHA t 1 PERMH7'*f PLICATt� r.t1 e,q °,,` 0:0100�I 111.14:041#. 0 , .. .t .; u � �, as ,` Type of Project: New _ Addn _Alteration Repair Type of Project: New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC–Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping j 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 1 SUPPRESSINON 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# -I l- Itj- / 6 M (60(- 045 Owner/Au 'Age t Signature Date (Revised 10/12/2015)