2502 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 � wv�nv.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: PROPERTY TAX #: ' � j v¢fL� LEGAL for new construction: ShoR Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: � �,� s� � �� TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTReer �� j/� � 7� `� � �✓,�i i � �J CITY f �/: �( /T STATE � � ZIP � � �O/ OWNER PHONE: OWNER EMAIL• �� i�,, �pL�/ ' S✓ G. �pf,� CONTRACTOR NAME: {� /- / �ir7 / % �/� � CONTRACTOR ADDRESS: srReeT 7 � � � Y (f IL CITY L��, %L J� STATE ti�� ZIP CONTRACTOR PHONE: C-j i� -`� "� fj �j ;" a CONTRACTOR EMAIL: p�; pE-. �/G �'.r� �/ �G " CONTRACTOR LICENSE #(REQUIRED): l��r%J''1 �►�7 ��/-/ Z� l� CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): G7�' °'�� i PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: �{ � �� I � � '�� �� S/-y� / �� CONTACTEMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contrect Price of Work: $ �� Proposed Use of Building: Heat Source: �as ❑Electric ❑Other Building Type: �'SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial Type of Project: ❑New ddition ❑Remodel ❑Repair ❑T.I. ❑Si n ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: (i� � �j 4= f� �f �1 p%, r' C � � �-� � C. S � 0 �� ► � �'. vi �� c• � i lr '" 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 #�f Lisi of Fixtures #°f List of Fixtures #°f List of Fixtures Fixtures Fixtures Fiztures 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 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 / SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT.' 1 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 Officia/ before bein ed under any circumstance. I am the owner, or I am authorized by the owner of this property to pertorm the work for which application is made, and / comp/y with t ate Contracto s Law 18.27 RCW and 296.200A WAC. � - ��G ��_ Agent Signature Date City of Everett Officral Use On/y PERMIT # �,+� �' �� -- >" � �' (Revised 10/12/2015)