2521 57TH ST SW 2017-03-10 - Laserfiche WebLink

OLT PERMIT APPLICATION BUILDIN€—IECHANICAL / PLUMBING / SIGN , 'RINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVIG 3 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: Z52i 57STS PROPERTY TAX#: py �aG�Ds'��,y ti LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal`description) CONTACT INFORMATION OWNER NAME: L(,((5 IAvtre__ f- 5U5,4,) T(A. TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 25,2( 5-�7J�61 51.A.) G CITY eVt-TL�( 1 STATE VIA— ZIP q Q Zc3 OWNER PHONE: L{ -eZ-C13 3ST,3 OWNER EMAIL: CONTRACTOR NAME: DiT L d- cre—Pu 3 .r-a- H exn n CONTRACTOR ADDRESS: $ STREET 16( 14- (3 • 1.0 CITY L-Y N W 00.0 STATE LAM- ZIP '10037 CONTRACTOR PHONE: rj-'77 110 CONTRACTOR EMAIL: 6 pcy j 6_O,A,j 0 it)jfe., veT CONTRACTOR LICENSE#(REQUIRED): f,44(W -OFj t.i-L(IN CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): g(q'q I PRIMARY CONTACT: Er OWNER CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: /-14),....5--7-)5-e0(`t# 13 '' C-e-t moi— CONTACT EMAIL: p BUILDING PERMIT APPLICATION �7�,�/; lilting Use of Building: Contract Price of Work: $ (�/ / b .QT rlU(Sosed Use of Building: Heat Source: 0Gas DElectric ❑Other Building Type: ❑SFR-Detached SFR-Attached El Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel El Repair DTA. ❑Sign ❑Sprinkler El Demolition ❑Change of Use DESCRIPTION OF WORK: i+h►51-ALL_ A A,e cm,c-cs,(be_ ,t 7--- Pt;tit'L 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 #of Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures A/C-Air Handling Units I 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 OWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with t 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 in ung 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/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Ilse Only ,4e PERMIT# r r / �-- !4 774 l �orfl - 0L5 Owner/Auth rized Agent S'.nature Date (Revised 10/12/2015)