5602 WEST DR 2016-11-07 - Laserfiche WebLink

PERMIT APPLlCATI BUILDIN�VIECHANICAL / PLUMBING / SIGN PRINKLER / 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 PROJECT SITE INFORMATION LEGAL for new canstruction: Short Plat/subdivision Lot No. (attach copy of long legal descriptionj OWNER NAME: �'j �� OWN�R MAILiNG ADDRESS: OWNER PHONE:-�-2 CONTRACTOR NAME: j� CONTRACTOR ADDRESS: STREET � C�%z CIIY ,�jl//�-��.1 ;tr'`� (� l� i,m STREET � ,� C% � CONTACT INFORMATION �v�^ TENANT NAME (If CommE 1�)��-�- I�--iv�C-. � STATE OWNER EMAIL:� (� % j,,V Q�, � �'1 � � 1'rifx��nrV1 ��- i� L�x.� n, n l� CtTY F ( U 1 CONTRACTOR PHONE: ��; � (� �( � ' � , CONTRACTOR LICENSE #(REQUIRED): (�C Pd�IEiZ PRIMARY CONTACT: ,�OWNER � CONTRACTOR CONTACT NAME: �Q�e � gr 1� �i (�I�«r Z1P STATE �`�j � ZIP �� EMAIL: �.lu I1). �OU�PX SC'.CYI . CDY1� TY OF EVERETT BUSINESS LICENSE #{REQUIRED): (7� �i ❑ OTHER (Please Specify) CONTACT PHONE: L CONTACT EMAIL: 3,5 � � BUILDING PERMIT APPLICATION Existing Use of Buildin : Contract Price of Work: $ •�' Proposed Use of Buildin : Heat Source: Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Muiti-Family-# of Units: ❑Commerciai ❑Industriai T e of Pro ect: �New ❑Addition ❑Remodel e ir ❑T.I. �Si n ❑Sprinkler ❑Demolition ❑Chan e of Use DESCRIPTION OF WORK: i-�,,C� �oi R�i" C�,�'1Re.� �rUm p�rvu.r� d�-o t�ernov�e. eh� m ne �t, tZo�i� n.e �; r . I,L �f¢.buu-�� Gh�`mn�� nn (Zon��h.� "� ��-2Ct'��G �1� r� �w �1�5 e� .ir.�}-a,.1� t•�cu� fuu.r.�kr -F(a.,�h,��ng � ert�n C�-ad-n ac� `�cbr i ASSOCtATED BUILDING PERMIT # (if applicabie): MECHANICAL PERMIT APPLICATION Type of Project: _New Addn Alteration Ftepair Fixtures �ist of Flxiures Fixtu es �ist of Fixtures A/C — Air Handlin Units Heat Pump Forced Air Svstems Unit Heater Gas Range Hood Exhaust Fan SPRINKLER / SUPPRESSION SYSTEM ACKNOWCEDGEMENT: 1 have reviewed this application and confrrm the information contained herein is frue and correct. Work done pursuant to this permit must comply wiih 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 O�cial before being authonzed under any circumstance. 1 am the owner, or f am auihorized by the owner of this property to perform the work for which application is made, and ! comply wrfh the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett O�cia! Use Only PERM�T # � � �b�b !��(�� -olZ- Ow Authorized Agent Signature Date (Revised 10/12/2015)