1516 HOYT AVE 2017-01-13 - Laserfiche WebLink

� � � i 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: �I �o F-�i � �v�C_ PROPERTY TAX #: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long Iegal description) CONTACT INFORMATION OWNER NAME: I�G� Y l S L.�. Vc�,r TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTREET � S(� 1�'it,j y' 7 �(� CIIY 'E'�v VC�"G STAl�E 4�� ZIP �� Z � OWNER PHONE: OWNER EMAIL: CONTRACTORNAME: f J t%� P� /��^ GL �- CONTRACTOR ADDRESS: sTREET ('f S(� �� 5��, SFL CI7Y �/� li�, J/'-L• ��1 STATE L✓�'G ZIP (�� v CONTRACTOR PHONE: L!a S i(� (� ?G U CONTRACTOR EMAIL: 'r/'C.� ��^� r ��-i+ It�p.Li: . col� 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: �r �� s.tn �� !�-.,1,�� ..a d �,SG_.�+Lfc� �ry� � rG�� /� — U IT �,•v�.�, s�, ,� ! � �--��-c chs✓ ASSOCIATED BUILDING PERMIT # (if applicable): MECHANICAL PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Fixtures List of Fintures Fixtures List of Fixtures 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 Fixfures List of Fixtures Fixtures List of 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: 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant io thrs permit must comply with current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must firsi be authorized in writing from the Building Officral before being authorized under any circumstance. I am ihe owner, or I am authorized by the owner of this properfy to perform the work for which application is made, and / comply with the State Contractors Law 98.27 RCW and 296.200A WAC. City of Everett Officral Use Only � �+/G�— ��— / —�r� PERMIT# � �� DQ� �� Owner/Authorized Agent Signature Date (Revised 5/20/2016)