1302 BROADWAY 2018-09-24 - Laserfiche WebLink

PERMIT APPLICATIO- BUILDING / MECHANICAL/ PLUM=INTO /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES �-T` - - 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (:lasm or Black lank Only Please) PROJECT SITE 'INFORMATION PROJECT SITE ADDRESS: / 3 C Z AL 3 ficA boJ(ki// /A 1-, PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) J CONTACT INFORMATION i OWNER NAME: TENANT NAME(If Commercial): 7 OWNER MAILING ADDRESS: STREET C.:1[Y STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: (ZAtNA-GcT SYS( &- s /CL�AAJtAJG CONTRACTOR ADDRESS: STREET�,D1 IS OX 4/6.15-4G' my v2/4TiGe--- STATE w 4 ZIP ?e/ CONTRACTOR PHONE:ZO(n—2'f2" Z$o CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): PRA l 45C. 54,6-41I K CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): `w ''\\U� PRIMARY CONTACT: ❑ OWNER CONTRACTOR 0 OTHER(Please Specify) rho Kt CONTACT NAME: CONTACT PHONE:3(oO -, 4(' /—'Z 17 0 8 os L-A-Tf-4e-. CONTACT EMAIL:dra.;,n a,t c_sY ._m 5 e 5 ma.l, o," iBU LDINO PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ AP‘7617 • ‘0 Proposed Use of Building: Heat Source: ❑Gas DElectric DOther Building Type: DSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: Commercial ❑Industrial Type of Project:/New DAddition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 1 6/1011,II rVe,w lwa \ t WAC k 4111 v- 46A-1 tk ►' .r1'Mevuf ,ASSOCIATED BUILDING PERMIT#(if applicable): �T _ MECHANICAL [PERMIT APPLICATION L PLUMCBI IC PE-'MIT APPLICATION [Type of Project: _New_ Addn _Alteration _Repair Type of Project: New _Addn Alteration _Repair #of #of #of #of Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove ' Kitchen Sink&Disposal Grease Trap Gas Range I Ducting Dishwasher Roof Drains Clothes Dryer Hookups I Other: Clothes Washer I Medical Gas Range Hood IWater Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Y Other: L SPRINGTLLEr-: /SUPPRESSION SYSTEM Chemical or Water [ 1No. 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 /�-/ z (5 1�� Owner/A thorized Agent i re Date (Revised 9/23/2016)