4512 HOYT AVE 2016-11-07 - Laserfiche WebLink

• PERMIT APPLICATIO� BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION 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 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: �� C� �,� �\' (i�� %�l"�' � PROPERTY TAX #: LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: � t" �l � L� S TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srHeeT ti" ' lr�� . CITY � STATE / ZIP � ) � G�� �- ,, �� f" , /-� , OWNER PHONE: � �j � ,� 'S OWNER EMAIL: )( /'�L'� � f �x; ��C�}77�''Ct��f .1 )E f CONTRACTOR NAME: �� ' ( �, � }� �=' ��-- CONTRACTOR ADDRESS: srReeT cirv srnTE 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 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: �-� � IC� C� G�S �vGL�--c �� ,I�v�--�� r � ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New Addn Alteration % Repair Type of Project: _New _Addn _Alteration LRepair - - - T # Of # Of # Of # Of Fixtures List of Fixtures Fixtures Listof Fixtures Fixtures List of Fixtures �ixtures List of Fixtures A/C — Air Handling Units Heat Pump Toilet Backflow Preventer (Inside Bldg) Forced Air Systems 1 L 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: . lothes Washer Medical Gas Range Hood Water Heater jC Other: Exhaust Fan Sink (Service/Bar/Mop/etc.) Other: SPRINKLER / SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT. 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this pe�mit 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. I am the owner, or I am authorized by the owner of this property to perform the work for which application is made. and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. Ownerll�utF�'orized Agent Sign City of Everett Official Use Only PERMIT '/ 3�� " ' � Date (Revised 5/20/2016)