709 107TH PL SE 2016-09-15 - Laserfiche WebLink

• PERMIT APPLICATION• BUILDING / MECHANICAL / PLUMBING / SIGN /SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 4M7 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: :�(;)IJ 10-4T14.P` 5 6 PROPERTY TAX#: 2+000004W LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: FAD LRescHcQ-c 146- E _ Z TENANT NAME(If Commercial): OWNER MAILING ADDRESS: -' R 0? 10:7 S6- CITY EV6t2,G77 STATE WA ZIP 9 O8 OWNER PHONE: nS 42 3 3640 OWNER EMAIL: CONTRACTOR NAME: FAUL. DAVIS IC_C�ST 2ATI tJ CONTRACTOR ADDRESS: STREET I 5o04- 35T0 G% CITY LANINW00b STATEWA ZIP C/6030 CONTRACTOR PHONE: 2((p 3pg Soo CONTRACTOR EMAIL: l� o� U�I�AVISvCc7 CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR -J&-OTHER(Please Specify) l —12. CONTACT NAME: CONTACT PHONE: 2S3 8335SS� LS5G 602 1 CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: I,r2 Contract Price of Work: $ Proposed Use of Building: Heat Source: d0n�s ❑Electric ❑Other Building Type: FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel epair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 9E AIIZ. IN1pI cc-- -4) p6 6xTEelO(Z (2 1EDe.00m W I ti�Qo N ,woof 1 N�-, iZuor SI4r-A 7 H i-k(;- 1 ty pt A OF ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION YJ IN PLUMBING PERMIT 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 List of 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 Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting IDishwasher 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: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 (2l )_ PERMIT# �I J Owner/Auth ' ed Agen ignat re Date (Revised 10/12/2015) � I Z