809 84TH ST SE 2017-03-13 - Laserfiche WebLink

4rerrPERMIT APPLICATION BUILDIN' MECHANICAL / PLUMBING / SIGH PRINKLER / 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 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) +PROJECT SITE INFORMATION PROJECT SITE ADDRESS: ® j c•K4' ST SG PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: tiv� � TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET )(j/ �fi }C A CITY STATE ZIP y 20 O v OWNER PHONE: Y Z /tel _ 33 �'s" OWNER EMAIL: P,4 PP y � � •Gr. 4 (-C.)V,,N, CONTRACTOR NAME: Ce_w 7,4 pa�� CONTRACTOR ADDRESS: STREET 143,3 t nGt (/ l.yc- k- CITY I°/�k1C4T,I / STATE G� ZIP �g"Z CONTRACTOR PHONE: -1/2„.. "-- - 2,2,?-2._ CONTRACTOR EMAIL: �Nz L t-s 4 caryf` CONTRACTOR LICENSE#(REQUIRED): (1`�l' ALL kiP tic'U 4 - CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (��5 .. r PRIMARY CONTACT: 0 OWNER Ca2c6NTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ("L- 7 '- 22, Z Int�t� L.C.ita.64 CONTACT EMAIL: �, C� <�/� �\}7U;✓t I�1tc �,Z i Ce2wA BUILDING PERMIT APPLICATION /�llFF11uQ Existing Use of Building: Contract Price of Work: $ �SVV Proposed Use of Building: Heat Source: ❑Gas 1=1 Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: ❑New ❑Addition DRemodel DRepair ❑T.I. ❑Sign ❑Sprinkler CI Demolition ❑Change of Use DESCRIPTION OF WORK: ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn , eration _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_I 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 , 67. PERMITM 01 - 1 - DID Owner/Authorized Agent Signature Die / (Revised 9/23/2016)