1910 JACKSON AVE 2017-03-02 - Laserfiche WebLink

._ PERMIT APPLiC.AT14#I / . .. BUILDINL I MECHANICAL/ PLUMBING I SIGH RINKt ER/ DEMOLITION .''�4' -mi-" CITY OF EVERETT PERMIT SERVICES \s,-•V. . <,- T 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@evereftwa.gov I www.everettwa.gov/permits ( 9,rt ,i. -(0ai4 ilu*.:Penlljs 0.11,0. .q.0 -.•'.. 0...040.0.0_ L 11 IPO .:: •®39. . • ... • .. _ -.....,:•••••••; PROJECT SITE ADDRESS: /el/ O .___AC KS o j AVL PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) . ::. . 0®i�iYAs;�'�IR9l�®��i11�`if'I®61 OWNER NAME: DONN Y $/1©U TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET /e)/t .5.":46-145'5(\....)AU-5 as _ CIN �V� STATEST2W� . ZIP �U OWNER PHONE ).,...2-65 r...5q.30N.......... ...r, OWNER „EMAiL: ,. . , ,,/1/7 ., ,. - .,,._ , ....:.., ... .. _.,...__ .. ,,,,. CONTRACTOR NAME: ( (=f?.a[ > t„ t-t , A�e- CONTRACTOR ADDRESS: STREET ..L Zo p�4-V LC.. CITY W(�( L STATE LOA ZIP l V CONTRACTOR PHONE: ( 25) 1.52-- ,51 (L4”. CONTRACTOR EMAIL: I° .@-£ iriel l.,Jw r Cd Ai CONTRACTOR LICENSE#(REQUIRED)- [—vC(ZL ycp err— - CiTY OF EVERETT BUSINESS LICENSE#(REQUIRED) rIv PRIMARY CONTACT: 0 OWNER `CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ((i.Zc) ,j6 ._072...2- . IL (a CONTACT EMAiL: LA_-4 a 65ny/teAyt.ar l - -..: :-. . '. ... :: • BUILDING.PERMIt.APPLI0ATI®ie! ;. ..•'. T �:..: ..' _Existing Use of Building: Contract Price of Work:$ •` ba), . Proposed Use of Building: Heat Source: ❑Gas 1 lectric ❑Other Building Type: SFR-Detached ❑SFR Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair 'T.I. ❑Sign ElSprinkler ❑Demolition ❑Change of Use • DESCRIPTION OF WORK: T oos, u a -24:Lc__ bae:6: 5 “e- ac si,srea-4., • ASSOCIATED BUILDING PERMIT#(if applicable): s__ :,••11.40014110.1C4 P RP IT APDL ATION - - • . '-•- PLUM2ING PERM T:APP.UcAtiOM Type of Project New Addn Alteration Repair Type of Project: New Addn Alteration Repair #of List of Fixtures °f List of Fixtures °f List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units i 1 Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems I 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: : .: r $0.;iINICLP L S PI R •�Sa:!.k.'.T'S` `E0f1. : - Number of Heads 1 ACKNOWLEDGEMENT:l 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.tam the owner,ori am authorized by the owner of this property to perform the work for which application is made, and/comply with the State Contractors Law . W and 296.200A WAC. // // City ofu Everett Official Use eOOnly ( O' '4 �1- `G l� 4 PERMIT n 1 `/ OA V 1.6 %"--"\ � �ll Owner/Authorized Agent Signature Date (Revised 5/20/2016)