2112 74TH ST SE 2017-03-13 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN /SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 0477-.7 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 PROJECT SITE INFORMATION PROJECT SITE ADDRESS: )) l 14-L. PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) / �i CONTACT INFORMATION OWNER NAME: M(t 1 ff/r 1 U(- rTENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 01514 L <1; .e✓1 CITYMik (' A V if � /(41/!' STATE 644 LIP 5--e()Li3 OWNER PHONE: ,2�(- 34A - �.' OWNER EMAIL: )(CVtvfoo V 4 )off' 4 i .(L'v 11 CONTRACTOR NAME: ,f(1-1 CONTRACTOR ADDRESS: STREET ,J`.f7{'L11• CITY STATE ZIP \CONTRACTOR PHONE: [ONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 7/0-U Proposed Use of Building:g: i' d;) 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: keptacc_ S�� t S D VL 1,-X05t , Cj '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 List of Fixtures #of List of Fixtures #of List of Fixtures 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: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. City of Everett Official Use Only 2/4/): PERMIT# Owner/Authorized Agent Signature Date (Revised 10/12/2015)