5021 HARBOR LN 2017-01-13 - Laserfiche WebLink

� PERMIT APPLICATION � 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: rJO2 � HarbOC LaC18 PROPERTY TAX #: OO73ZHOOOOO 'rJOO LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION owNER NAME: Mary and Jack Johnston TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srReEr 5021 Harbor Lane �„-�, Everett STATE WA Z�P 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: DBflllafl .JOilfl If1Stallatl0flS CONTRACTOR ADDRESS: srReer 12310 Highway 99, STE 110 ciTv Everett srATe WA ziP 98204 CONTRACTOR PHONE: 4Z�J-3ZZ-�J�J3O CONTRACTOR EMAIL: SCi1BCIUIl11 damian�ohninstallations.com CONTRACTOR LICENSE #(REC2UIRED): DAMIA�CH7rJBG CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): b5(p Z�� PRIMARY CONTACT: ❑ OWNER r/7 CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: 425-322-553� Kelly Fox CONTACTEMAIL:SCIIeCIUIICI damian'ohninstallations.com BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price o ork: $ 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: � �� ASSOCIATED BUILDING PERMIT # (if applicable): 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 #�f List of Fixtures #°� 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 1 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 Hood Water Heater Other: Exhaust Fan Sink (Service/Bar/Mop/etc.) Other: SPRINKLER / SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT: I have reviewed this application and confirm the informafion confained herein is true and correct. Work done pursuant to this permit must comply with current federal, state, and loca/ law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must (irst be authorized in writing from the 8uilding Official before being authorized under any circumstance. I am the owner, or I am authorized by fhe owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. Agent City of Everett Official Use Only �� Q? P�`�,#�c�c � o�- ate (Revised 9/23/2016)