1720 EDGEMOOR LN 2017-04-10 - Laserfiche WebLink

PERMIT APPLICATION BUILDING 1 MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION OIL CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 ((E)everetteps@everettwa.gov I www.everettwa gov/permits PROJECT SITE INFORMATION PROJECT SITE AD KESS: LEGAL for new consiturti Sri Short Plat subdivision __ _Lot No (attach copy of long legal description) i CONTACT INFORMATION i OWNER NAME: + y TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srHr_rrr r Lanc- 'i Clyf, W ?iP OWNER PHONE:9Z5' 1 6—c t OWNER EMAIL: 1\! A CONTRACTOR NAME:1.urnta--tsfyne- CONTRACTOR ADDRESS: sTRFFT C—, 10 1 cilY t STAIE. NA 7IP 0 CONTRACTOR PHONE: 412.,5 65 Q 111 1 1CONTRACTOR EMAIL:,�j(3.YGL(� �C�Y►1eX`�}O►1Q_YOUF`Yt C-3YY1 CONTRACTOR LICENSE MRFQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR (�KQTHER(Please Specify) , ' CONTACT NAME: (� r�1 1� tX. CONTACT PHONE: '- lJ CONTACT EMAIL: rm'% - BUILDING PERMIT APPLICATION Existing Use of Building:SkO Contract Price of Work: $ O Proposed Use of Building. u Heat Source ❑Gas ❑Electric ❑Other Building Type ❑SFR-Detached SFR-Attached ❑Duplex ❑Multi-Family-#t of Units ❑Commercial ❑Industrial Type of Prcect: ❑New ❑Addition ❑Remodel Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Chan e of Use DESCRIPTION OF WORK: r{,1rYlov I n I SyiaV.c_. ro v�, rC Y-oofi n j vrV r comp. ASSOCIATED BUILDING PERMIT#(if applicabte) 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 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 I,Grease Trap Gas Range Ducting Dishwasher Roof Drains Cloths 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 It I ACKNOWLEDGEMENT:1 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 ordy authorizes approved work and no deviations therefrom Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance 1 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 Use Only i ,.^ PERMIT# owner)Authorized Agent Signatureate' (Revised W112912015) 1