7100 HARDESON RD 2016-08-05 - Laserfiche WebLink

PERMIT APPLICATION BUILDINIMECHANICAL / PLUMBING / SIGPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVIC S 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 0 6 f_ / PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision a Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: L ,vL / T N TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY Z.E STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: G CONTRACTOR ADDRESS: STREET CITY / STATE ZIP 7 CONTRACTOR PHONE: o&- I CONTRACTOR EMAIL: �>(,t re e. G CONTRACTOR LICENSE#(REQUIRED): bUC�j� L-&— CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONT .. ... .. ACT: DOWNER O CONTT RACTOR El OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: GufitfG� < �G "� G• G UZ2�[ BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 7 � Proposed Use of Building: I Heat Source: ❑Gas ❑Electric []Other Building Type: ❑SFR-Detached ❑SFR-Attached []Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: El New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: k ?1UU1 a /P ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION 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 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 I 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: L SPRINKLER/SUPPRESSION 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 der 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 Cont ors L 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner/Authoriz gent Signature Date (Revised 10/1212015)