1025 52ND ST SE 2016-11-01 - Laserfiche WebLink

PERMIT APPLICATION BUILDINWECHANICAL/ PLUMBING /SIGIPRINKLER I DEMOLITION CITY OF EVERETT PERMIT SERVI 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: c — PROPERTY TAX#: Q C'O LEGAL for new construction: Short Plat/subdivision J Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: V I %A LYS/ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 102 — `' L- CITY STATE �'��- ZIP ��El OWNER PHONE: zLA 1 Z OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: - CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATIOTI Existing Use of Building: ontract 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 El Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Chan e of Use DESCRIPTION OF WORK: )(� W\C jq M lI Lr' S�cte- Qvtd U S),4--c—d--c t er-k,�!�a. �c� / `( C,.,� yc Io ASSOCIATED BUILDING PERMIT#(if applicable): CA-7-,4 101660AJ 600P 0077 '/tDlr— 01- 51 L764r—k MECHANICAL.PERMIT APPLICATION _ PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: —New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures 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 Flood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/_SUPPRESSION SYSTEM._.. . : Number of Heads ACKNOWLEDGEMENT:t 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/comply with the State Contractors Law 98.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT l U04— — 00 1 Owner/Authorized Agent Signature Oate (Revised 90/92/2095)