2114 MAPLE ST 2016-08-24 - Laserfiche WebLink

• PERMIT APPLICATION• BUILDING ! MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 • (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: a��,y � � II_�� PROPERTY TAX #: Q �SIS t/�/ 9 d c�Sa(7 �� LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: /�}' lJ�� 7 fornPso r�/ TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTReeT e2 �/�/ CITY STATE �/7' ZIP / V� �I OWNER PHONE: o2O(Q. — S I%� 3 OWNER EMAIL: CONTRACTOR NAME: �-rLQ.!'S' h � • CONTRACTORADORESS: sTReEr 7 1�'�`��^- /j�1� � '�IOfi� CITY STATE �//�% ZIP / O� CONTRACTOR PHONE: 'yo?�`--�/�S � �II� CONTRACTOR EMAIL: p.�R @�"I'�l�cS'�9-r�2 - G�--� CONTRACTOR LICENSE #(REQUIRED): CQ�QN � le-r�1-.�Ch'1 CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 3 S PRIMARY CONTACT: ❑ OWNER C�CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: ao G- 7�� ` 6�'�/� C�K�I G Yli/ CS�/Q__ CONTACT EMAIL: (��' o� C6!-/111i�-d , GB-�-�ti BUILDING PERMIT APPLICATION Existin Use of Building: � %�g�>.Q� Contract Price of Work: $ �%S�v• �� Proposed Use of Buildin : Heat Source: ❑Gas ❑Electric ❑Other Buildin T pe: ❑SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Famil -# of Units: ❑Commercial ❑Industrial T pe of Pro'ect: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Chan e of Use DESCRIPTION OF WORK: /� �,, _ _ /C:Q�'p 0✓'e �� a P.Y � G9'►'y� 9L �,p�Q G¢ �cn ��'6"�'`�q�i''�'rB�'1 . �- - - ASSOCIATED BUILDING PERMIT # (if applicable): PLUMBING PERMIT APPLICATION Type of Project: New Addn _Alteration Repair # of List of Fixtures # of List of Fixtures Fixtures Fixtures Toilet Backflow Preventer (Inside Bid ) Bathtub Urinal Lavatory (Wash Basin) Drinkin Fountain Shower Floor Drain Kitchen Sink & Disposal Grease Trap Dishwasher Roof Drains Clothes Washer Medical Gas Water Heater Other: Sink (Service/Bar/Mop/etc.) Other: ACKNOWLEOGEMENT: I have reviewed this appfication and conlirm the inlormation contained herein rs true and correct. Work done pursuant to this permit must comply with cunent lederal, state, and local law. The granting of a permrt only authorizes approved work and no deviafions therelrom. Deviations must lirst be authorized in w�iting lrom the Building OHrcral before being aufhorized under any circumstance. / am the owner. or I am authorized by the owner of this property to peAorm the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. Signature City o/ Everett ONicial Use Only PERMIT # a�7 02011� �((oOZ.-�o�� ate (Revised 10/12/2015)