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1814 BAKER AVE 2017-04-19
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1814 BAKER AVE 2017-04-19
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Last modified
4/19/2017 9:33:23 AM
Creation date
4/10/2017 10:03:46 AM
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Address Document
Street Name
BAKER AVE
Street Number
1814
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PERMIT APPLICATION--• <br /> BUILDIN■ I UIECHANICAL/ PLUMBING /SIGN INKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: j 11-( K {2) tV I / PROPERTY TAX#: po 2 010 <br /> LEGAL for new construction: Short Plat/subdivision Z J—2k� LOTS Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 1 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET L( (-� �j !� <br /> CIT' / E79 } J E W ( &20( STATE ZIP �1�zLJ <br /> OWNER PHONE: ,2^ (.(Z OWNER EMAIL: K NC& <br /> CONTRACTOR NAME: . <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: C�-bWNER ❑CONTRACTOR ❑OTHER(Please Specify) 14'25'-L4 <br /> 1 7 , <br /> CONTACT NAME: 4� E V N O1� VA tG H �L-L CONTACT PHONE: 4J-2 2_' 7LI Z 14 Z�-L4 be <br /> G CONTACT EMAIL: ���V ��J e) 0E/V P E 0T-- (U N r 'NU P 1' <br /> 11 BUILDING PERMIT APPLICATION <br /> Existing Use of Building: ?0 P-T- Contract Price of Work:$ Soo, <br /> Proposed Use of Building: fl- P Heat Source: ❑Gas ❑Electric []Other t�N <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: --❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler Demolition []Change of Use <br /> DESCRIPTION OF WORK: F vwoUT-;'t � C n <br /> V <br /> 7X 2 tv�r �' IAi67 A . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_ Addn _Alteration _Repair Type of Project: New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number of Heads <br /> 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 <br /> 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 <br /> Building Official before being authorized under any circumstance.I am the owner,or/am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> Owner/Authorized Agent Signature Date (Revised 5/20/2016) <br /> �v <br />
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