117 FOREST CT 2016-08-22 - Laserfiche WebLink

Nov 16 15 03:09p p.1 0 PERMIT APPLICATIOAD BUILDING / MECHANICAL/ PLUMBING !SIGN I SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 {P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS:1 i yf, �. 5 C.•1 ` PR lOPERTY TAX#: LEGAL for new construction: Short PlatlsubdVsion � Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAM E: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Det;, (�7 CITY L)T/fes ✓1 Ur CJ` STATE ZIP OWNER PHONE: S �C ) I OWNER EMAIL: CONTRACTOR NAME: f 1 0�5�12 ea .i) l--4 L K— CONTRACTOR ADDRESS: STREE- //�� CITY Y 1 STATE Vim, I^ ZIP CONTRACTOR PHONE:Z4J j'�� `L-(. 0 CONTRACTOR EMAIL: YIGYdStr�-m CONTRACTOR LICENSE#(REQUIRED): 11 D >rGiShCt C J jLf� ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED):(- �4 PRIMARY CONTACT: ❑ OWNER EVONTRACTOR ❑OTHER(Please Specify) CONTACT'NAME: CONTACT PHONE: ► Y,�1'� L� J C// CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Sou roe: Was ❑Electric ❑Other Building Type: OSFR-Detached EFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: t c f�j L r-) rpt GIC G !-1 t�� ✓� C (�n 14- ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _RepairType of Project: New —Addn _Alteration _Repair #of of Fixtures List of Fixtures Fixtures List of Fixtures #°f Fixtures List of Fixtures #of Fixtures Lisr 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 lGrease 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/Mopletc.) Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT i have reviewed this appf;cation and confirm the information contained herefn 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.Deviatfons must first be authorized in writing from the Building Official before being authorized underany circumstance.i am the owner,or I am authorried by the ownerof this property to perform the work for which application is made, and t c p with the State Contractors Law 18,27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# _ � ^ Owner ulhoraed enCgDate (Revised 10/12!1015)