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10725 WASHINGTON WAY 2017-01-18
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10725 WASHINGTON WAY 2017-01-18
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Last modified
1/18/2017 10:40:15 AM
Creation date
1/18/2017 10:40:10 AM
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Address Document
Street Name
WASHINGTON WAY
Street Number
10725
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PERMIT APPLICATION <br /> ,IIPie..--A BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION <br /> , CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Bl,ue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1072 5" iif. //()G7O91/� PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:76-Aev c74- 7-6.E TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET /Q-72 S 0, /1<mh6'Tfjjv )4V ,'// n^N <br /> ' / <br /> CITY iEv,E2iEr7-_ STATE 40,64¢ ZIP Ig2 <br /> OWNER PHONE: 4 Ni 899EMAIL: ///' OWNER <br /> CONTRACTOR NAME: �(fi/2E77 - eitilLDI. / e.- ` J <br /> CONTRACTOR ADDRESS: STREET �Jj98' y/3 i /" / A) <br /> J�' , — .7 <br /> CIT1--P. <br /> Y .�)4r '�� STATE pe/44- L <br /> - ZIP Z� <br /> CONTRACTOR PHONE: 4/2"------55-3-- 7/ ,/ CONTRACTOR EMAIL: ___c -�� .y <br /> CONTRACTOR LICENSE#(REQUIRED): ,frV c'R�8 3p/ pi-; CITY OF EVERETT BUSINESS LICENSE#(REC IIRED):�77Z <br /> 7 <br /> PRIMARY CONTACT: ❑ OWNER gCONTRACTOR ❑OTHER(Please Specify) . <br /> CONTACTJdri( <br /> //G�NAME: CONTACT PHONE: z7/2.5-- 353— 7(6 <br /> G� �j CONTACT EMAIL: __ ' <br /> /f ��� <br /> BUILDING PERMIT APPLICATI <br /> Existing Use of Building: S f�P Contract Price of rk:$ ,._36)6 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric DOther <br /> Building Type: SFR Detached ❑SFR Attached ❑Duplex ❑Multi Family#of Units: ❑Commercial ❑Industrial <br /> Type of Proje t: ❑New DAddition DRemodel CI Repair DT.I. ❑Sign ❑Sprinkler DDemolition DChange of Use <br /> DESCRIPTION OF WORK: r <br /> 4-.0 o tel/9-rt, cryosr- * LA v /N fix,s'n•c�6 <br /> C'G0.sc 7- <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration _Repair Type of Project: New Addn I Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC-Air Handling Units Heat Pump / Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler / Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas FireplaceWood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> 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 <br /> Building Official before being authorized under any circumstance.I am the owner,ort am authorized by the owner of this property to perform the work for which application is made, <br /> and I corn with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> T# <br /> a/‘( *aldtA., /1— Z2-- &' (40 C .- 0 <br /> Owner/Authorized Agent Signature Date (Revised 5/20/2016) <br />
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