2232 MCDOUGALL AVE 2017-03-03 - Laserfiche WebLink

41ETT PER KATION BUILDIN—'IECHANICA PLUMBING /S SPRINKLER I DEMOLITION CITY OF EVER1=TT-PERMi SERVICLJ 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps©everettwa..ov I www.ever-ttwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION groom .. 4 /� j�� .) PROJECT SITE ADDRESS: " ' i gf4(F At;e_ PROPERTY TAX#: I i ' �LI�(!1 �) LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION • OWNER NAME: ,J'' y k - 4Pn TENANT NAME(If Commercial):^' /It. P O A.Lf 1 OWNER MAILING ADDRESS: STREET �' .RNLgLG ` ► 2� j VW'I�OV4�, 1 l V-E.R.e"--14- CITY STATE W A. , ZIP 7C.,Z c) OWNER PHONE: OWNER EMAIL: 11-CONTRACTOR NAME: 4 act Z ?2"t yytbA S L t o!/15- CONTRACTOR ADDRESS: STREET /3t) •- #9 CITY . ed 'o LJec22-e STATE w A _ ZIP 0 2-9 -J CONTRACTOR PHONE: 3 6b - 7z9- 'i 0? Cal EMAIL: ajet.z.S01,,,,-h•p 1451 6 pld,`.Cc ii4 CONTRACTOR LICENSE#(REQUIRED): J7/4 2 pj_ D Z Q y Z ;2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):ii; e,t'V /\�? miYPRIMARY CONTACT: OWNER ❑ CONTRACTOR 0 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: U --X U W V ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION ‘UMBING/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/ SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT .:ve 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 .i local I. . The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official b o--b-'•.authorized un.- 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 w. the •ate ctors ./18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner/A oriz gent Signature Date (Revised 5/20/2016)