3802 KROMER AVE 2016-09-30 - Laserfiche WebLink

PERMIT APPLICATIOPO BUILDING ECHANICAL / PLUMBING / SIGN RINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES OL3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 3SO?' Ki-u y+ q-(L PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) �n CONTACT INFORMATION OWNER NAME: 'SMA L56-714 TENANT NAME (If Commercial): OWNER MAILING ADDRESS: STREET 8V. QI)N - PTUf9 CITY fl�w STATE ZIP 2-0 OWNER PHONE: ZCJ' 530 o)-70 OWNER EMAIL: CONTRACTOR NAME florIvle AA Iii CONTRACTOR ADDRESS: STREET �2� D, I q O �7 r CITY j�l�YSTATE �� ZIP 17P9 CONTRACTOR PHONE: 1 CONTRACTOR EMAIL: Qar $1� ri Uv✓de �, Do .Cawk CONTRACTOR LICENSE#(REQUIRED): �� LL. CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): U� PRIMARY CONTACT: OWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: jjj , -� jg - p B 3 IFeaL CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: Proposed Use of Building: Heat Source: Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-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: WSTk'L,t W3 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 #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 I Dishwasher IRoof 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 Official before being authorized under any circumstance. 1 am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors to and 296.200A WAC. City of Everett Official Use Only �J PERMIT -7L521b Owner/Autho zed Age'At Signature Date (Revised 5/20/2016)