1801 BAKER AVE 2016-11-07 - Laserfiche WebLink

� PERMIT APPLICA710� BUILDIfVV / MECHANICAL / PLUMBING / SIGN /�PRINKLER / DEMOLITIOiV CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits (Biue or Black Ink Only Please) PROJECT S17E INFOlZM/�TIOM PROJECT SITE ADDRESS: /�% �� ✓� PROPERTY TAX #: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: � Lfr G� - � TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srR�er ��+ . �f( '�F CI'iY r V�iR �� STATE ZIP ��i' j OWNER PHONE: �� 7-' �'�J - c'.� y � OWNER EMAIL: CONTRACTOR NAME: �'J.�'1 :� SI=I� ��-�L�E ' p r— S/�..�% �>!�- �.S � CGc�,J� CONTRACTOR ADDRESS: s-rREEr %�s�, L U`�' _ cirv �if'E�Lc STATE e1.%. zia ' Ci CONTRACTOR PHONE: '�L�� .355 - r% L CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): ��N�US ��lJ jf- CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): V PRIMARY CONTACT: �I OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: l�i1 �-_ �j _ U" � �� 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 DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ��(,��_ H�� C,q�L� �- �� .�� ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Fixtu es List of Fixtures Fixtures List of Fixtures A/C —Air Handling Units Heat Pump Forced Air Systems Unit Heater Gas Piping Boiler Water Heater Refrlgeration Gas Fireplace . Wood Stove Gas Range Ducting Clothes Dryer Hookups Other: Range Hood Exhaust Fan SPRINKLER / SUPPRESSION SYSTEM Number of Heads PLUMBING PERMIT APPLICATION Type of Project: �New _Addn _Alteration _Repair # of List of Fixtures #°f Lisf of Fixtures Fi�rtures Fixtures Toilet Backflow Preventer (Inside Bidg) Bathtub Urinal Lavatory (Wash Basin) Drinking Fountain Shower Floor Drain Kitchen Sink & Disposal Grease Trap Dishwasher Roof Drains Clothes Washer Medical Gas Water Heater Other: Sink (Service/Bar/Mop/etc.) Other: ACKNOWLEDGEMENT: ! have reviewed fhis 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 granfing of a permif only authorizes approved work and no deviations therefrom. Deviations musf first be aufhorized in writing from the Building Official before being authonzed under any circumstance. 1 am the owner, or l am authorized by the owner of this property fo perform ihe work for which applicafion is made, anrf I comply with the State Contractors Law 18.27 RCW and 296.2o0A WAC. nature Date City of Eve�eft Official Use Only PERMl�� V � r U �� �,- (Revised 5/20/2016)