310 BEDROCK DR 2017-02-24 - Laserfiche WebLink

I 0.p,_ PERMIT APPLICATIOBI BUILDING-MECHANICAL / PLUMBING / SIGN 'RINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:o,, �2 Tice,c\L„ 1A2 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:D P.eA, \1\\J ems to fl t TENANT NAME(If Commercial):. \2�jC 1° OWNER MAILING ADDRESS: STREET\OJ' ! ) �( �,p� � 2i23 CITY _Q1-)tj "_C, STATE�A ZIP bC c OWNER PHONE:9 33 LAW\- b(i.y OWNER EMAIL 3C\ ( ! J� ,C nm CONTRACTOR NAME: 0�.v,�.2 T )0\AnCIAI CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: DOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: / CONTACT PHONE: t `,.Ccs 1 <�Q-;- a �� CONTACT EMAILarn (Mi st\t.pint iiv, t miry-) BUILDING PERMIT APPLICATION I Existing Use of Building: �)'[ Contract Price of Work: $ ZOO .0 Proposed Use of BuildingEQ�j'cu_ma iixRsvpf Il Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached uplex G Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: .i-----c4- ,4- \mac,,w' ca.1-1" Gc--OJ rw1 c,A01 u-- P FAct se 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 #of List of Fixtures #of 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 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 I SUPPRESSION SYSTEM Number of Heads 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 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. \n A \°C7 City of Everett Official Use Only /� l/ PERMIT#.- 1 2()7 ()7 — 0 3 7 Owner/Authorized Agent Signature Date (Revised 5/20/2016)