3112 TULALIP AVE 2016-10-21 - Laserfiche WebLink

Apr 04 16 11:41 a p,2 BUILDING'MECHANICA PERMIT APPLICATION L I PLUMBING I SIGN I SPRINKLER f DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gcvfperrnits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision l Lot No. (mach copy of long legal description) CONTACT INFORMATION OWNER NAME: hy( e--.::A--t I/it TENANT NAME(If Commercial): 6end I'til OWNER MAILING ADDRESS: STREET CITY /V - V v`•" SPATE ^C/� ZEA r �C/ OWNER PHONE:L4,-)� - G - Lj ,� OWNER EMAIL: CONTRACTOR NAME: C)o, -ea-+ i ISG -t- CONTRACTOR ADDRESS; SITTREET L�� I � � 7 � V) E- '' 11 CY 1Y l a/r 11 1 1 I� E 'STA706'-- zip CONTRACTOR PHONE: `"t . S- a�3�5- v A CONTRACTOR EMAIL: {)D-GlS jvy�-kn CG% Z CONTRACTOR LICENSE#(RELlUIRED): (jY Eji1(ik "I �S ILV 1 CITY OF EVERETT BUSINESS LICENSE#(REiQU1RE©)04 a--7q ! PRIMARY CONTACT: ❑ OWNER PkONTRACTOR ❑OTHER(Please Specify) CO TACT NAME: CONTACT PHONE: l l�t� i✓ Y a L�-� CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: S Proposed Use of Building: Heat Source: Mas ©Electric ❑Outer Building Type: ❑SFR-Detached L FR-Attached QDuplex ❑Mufti-Family-#of Units: []Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel epair ❑T.I. ❑Sin []Sprinkler ❑Demolition []Change of Use DESCRIPTION OF WORK: 4SSOCIATED BUILDING:PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLIC,9ITION type of Project: _New Addn _Alteration Repair Type of Project: New —Addn —Alteradon Repair #of Fixtures List of Fixtures List of Fixtures #of Last of Fixtures #of List of Fixtures Fixtures 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 Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink ServicelEar/Mop/etc Other: SPRINKLER I SUPPRESSION SYSTEM Number of Heads CKNOWLEDGEMENT-f have reviewed this application and cont rm the informatlon contained herein is true and correct_Work done pursuant to this permit must comply with rrrent federal,state,and locallaw The granting ofa permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the wilding Offfcia f before being authorized under any circumstance,t am the owner,or f am authorized by the owner of this property to perform ma work for which appt;cnfion is mads, no I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only _ r IT 1wnerlAulh��o�nzzeed Agent Signature pate �I� (Revised 1011212015)