7431 MCDOUGALL AVE 2017-03-09 - Laserfiche WebLink

14E-TTPERMIT APPLICATIOi BUILDING-- .JIECHANICAL I PLUMBING I SIGFWt!PRINKLER I DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: .. 1 }- 1 (,;J)`A F�RQPERTY� TAX#: LEGAL for new construction: Short Plat/subdivision I f 7VLot No. (attach copy of long legal description) CONTACT� INFORMATION� OWNER NAME: b) VD U-h ly,i1l., -1 It a �,c4114N�/NTNAME(If Commercial): OWNER MAILING ADDRESS: STRE -1 L 3 1 me/N �f , , ` . CIN STATE 1A.fl . ZIP t. p art)3 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: (OWYLQ/1/ CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: '.)-L^1 tit\-11l Ci �V l'l�Y CONTACT EMAIL: � J 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: El Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign CI Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: V - 17lpt AU6u V v 4 1 In. ) 1 65 v�'f -ki.lil 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 #of #of List of Fixtures #of List of Fixtures Fixtures List of Fixtures Fixtures List of 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: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 compl with the State Contractors Law 18.27 RCW and 296.200A WAC. PERMIT# City of Everett Official Use Only / 'ery r W (�v ni\ U`1 l.//�� (96- teU Ow - Au, orized Agent S ature Date (Revised 10/12/2015)