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5221 SOUND AVE 2016-10-21
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5221 SOUND AVE 2016-10-21
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Last modified
10/21/2016 8:44:17 AM
Creation date
10/21/2016 8:44:15 AM
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Address Document
Street Name
SOUND AVE
Street Number
5221
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PERMIT APPLICATIOI* <br /> BUILDING MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> OL (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: S-2z / .-S -, - JvQ I PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: VZ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET S11t.4Q <br /> CITY i '2 e-" STATE C ZIP f Lf`O <br /> OWNER PHONE: 2,-5--3 2-7— 5— OWNER EMAIL: C ' ve c7/1 7 �/ , C.Gi -'V� <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET c_ j-� t!z ct l VJc <br /> CITY C STATE ZIP 7 <br /> CONTRACTOR PHONE: Z--)6 r._ / LJ 7 Z-6CONTRACTOR EMAIL: d N L Sa A)t/ZG y S 5 <br /> CONTRACTOR LICENSE#(REQUIRED): e r/),Iy CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 511,7 <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 6 7 <br /> G r\ tc ✓1 �� CONTACT EMAIL: �� fjLpSN Nt=,L� S r C �t1 S ,C F� <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: S)CC,v�L y Contract Price of Work: $= '6 Cf'c��, <br /> Proposed Use of Building: Heat Source: ❑Gas []Electric ❑Other <br /> Building Type: ❑SFR-Detached SFR-Attached []Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial <br /> Type of Project: ❑New ❑Addition []Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads <br /> 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 <br /> 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 <br /> Building Official before being authorized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> K_ ZG <br /> v. 1 <br /> Own rlAuth/ized Agent Signature I Efate (Revised 5/20/2016) <br />
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