120 75TH ST SW 2017-03-13 - Laserfiche WebLink

PERMIT APPLICATION /1110 --a BUILDING =CHANICAL / PLUMBING / SIGN _ RINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2._() 7 ca-, S_k__ (t,"1_rPROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 7 (A V\v\-e- i a(ik_(/,/1Q TENANT NAME (If Commercial): OWNER MAILING ADDRESS: STREET 2i() -7 'C----r 'y-t- tc,..J A 7 CITY �,. V L,V. . t t/'-)STATE ZIP c V)GAV3 OWNER PHONE: L - Si 2— 15 i. OWNER EMAIL: CONTRACTOR NAME '- LA 'e, 1w - !-}r---eU-1,V• 1 yl__ CONTRACTOR ADDRESS: STREET -1 t k (P 7....-7---01-1-- % J 41- \ CITY IV a v4 fr A J e, 11- STATE w A ZIP c D L 3 CONTRACTOR PHONE: LA.-2-- ---1.-\ `- -1 ` CONTRACTOR EMAIL:\V`f b 9 to l.ie e frAre t.' t. C t' tj CONTRACTOR LICENSE#(REQUIRED):1LIJ' V c„. ,.-1--e, CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):(.S--Z---9 0 PRIMARY CONTACT: 0 OWNER V.CONTRACTOR 0 OTHER (Please Specify) CONTACT NAME: q CONTACT PHONE: ��--T7 t f=1 1 6 1 �-��L C�{/\ I�/v�� t2/ CONTACT EMAIL:\ :�[L{,e^%ltitl `I1/�Pc I��/�,,..12\c-i-./Lith/\. BUILDING PERMIT APPLICATION J �---1.) Existing Use of Building: Contract Price of Work: $ r-� Proposed Use of Building: Heat Source: Gas ❑Electric ❑Other Building Type: ❑SFR-Detached nSFR-Attached EDuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. El Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: -1) —5 %V( KVO C,e C,ki.11/l e 0 LA_+- ASSOCIATED BUILDING PERMIT# (if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn Vl4lteration _Repair Type of Project: _New Addn Alteration Repair #of List of Fixtures #of List of Fixtures #of #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 PERMIT# _ I ( Uu 1 (a0`-3 -CO Owner/Authorized nt Sigriatuge Date (Revised 10/12/2015)