3308 COLBY AVE 2016-11-07 - Laserfiche WebLink

PERMIT' APPLICAI"I BUILDW�MECHANICAL / PLUMBING / SIG . �PRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettv✓a.gov � www.everetiwa.gov/permits ,I P120JECT SITE INFORMATION ! PROJECT SITE ADDRESS: �(}t �/� „ PROPERTY TAX #: I� 1�11� Q� LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION E: � ��, � ENANT NAME (If Commercial): . S1�REET � J �$�'Y(�LC. CITY STATE � � - ZIP �!� �. � OWNER PHONE: � Z5 — Z�.� �- �,j OWNER EMAIL: �, , S �,� �u, n �� , C,z,�-�✓� CONTRACTOR NAME; ' D 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) C NTACT NAME: CONTACT PHONE: �-� Z� —�j�j 3- ZSU� � ,.,�iN� C��.Q�' 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: �,,,,/�, Q��G� L, `�� `q� i /'j'� �� U� G�S � 1 � �-��X � �vu w "1p �v L� (� �'�,�s�� W� ��v� `� f ��r,�+� L Q�� ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Fixtu es List of Fixtures Fixtures List of Fixfures A/C - Air Handling Units Heat Pump Forced Air Systems Unit Heater Gas Piping Boiler Water Heater Refrigeration 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 Fixfures Fixtures Fixtures Toilet Backflow Preventer (Inside Bldg) 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: I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to fhis permif musf comply with current federal, sfate, and local law. The granfing of a permit only authorizes approved work and no deviations therefrom. Deviations must first be aufhorized in writing from the Building Official before being autho�ized under any circumstance. 1 am the owner, or I am authorized by the owner of this property to perform the work for whrch application is made, and l comply with the Sfate Contracto�s Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# �, y(� � _� � C ,� , _Q� Z_22-_� � ��d Owner Authorized Agent Signature Date (Revised 10/12/2015)