9001 AIRPORT RD 2017-05-15 - Laserfiche WebLink

PERMIT APPLICATIC BUILDINU I MECHANICAL / PLUMBING / SIGN I SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:qA 19,kx KQ [4c CTT PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: t t C C r TENANT NAME(If Commercial): _ T2 OWNER MAILING ADDRESS: STREET C1AZ l Qr y CITY STATE JrA ZIP S`� OWNER PHONE: "c[ - OWNER EMAIL: N �>IF-_- IOU CONTRACTOR NAME: i CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR -OTHER (Please Specify) CT, .tk-at�{2�1L,�C�S�� CONTACT NAME: CONTACT PHONE: 4a-(�' �. d CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: t�'i Contract Price of Work: $ (� yNt� Proposed Use of Building: t \leq_ k\2PLiN 4Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ®Commercial ❑Industrial Type of Project: INNew ❑Addition ❑Remodel ❑Repair ❑T.l. []Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK:� �- t' c"' 241 1 wtlw DO) ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Rep ai Type of Project: _New _Addn _Alteration _Repair #of #of #of71 Fixtures List of Fixtures Fixtures List fixtures #°f List of Fixtures List of�xtures Fixtures Fixtures A/C-Air Handling Units t Pump Toilet Backflovy-P'reventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal" Gas Piping Boiler Lavatory(Wash Basin) Dirinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink—&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes DryerTigokups Other: Clothes Washer Medical Gas Range Hoper I Water Heater e Other: Exhau an Sink(ServiceBar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Number of Heads 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 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# t Owner/ horize ent Signature Date (Revised 9/23/2016) a