6521 EVERGREEN WAY 2017-05-23 - Laserfiche WebLink

PERMIT APPLICATION BUILDI (MECHANICAL/ PLUMBING/SIGN (SPRINKLER/ DEMOLITION II CITY OF EVERETT PERMIT SERA 3200 CEDAR STREET,EVERETT,V1 A 5u of (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits l�Iltie.:® .f l cl .Ievls.®ro9y f?Le sem) 1P.f ®.SECT S TE INFOR1lfl8 I.®" - PROJECT SITE ADDRESS; 41,� (A09W.)1PROPERTY TAX M LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) :... . .CONS-ACT INFOR ATION . OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE Zip OWNER PHONE: OWNER EMAIL; CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET/752V Z04.4tA A' CITY st��(� STATE �I� �ZIIPP,,14Y2 7/ CONTRACTOR PHONE: �1� 21-0- f�Z7 p CONTRACTOR EMAIL:AMA S7J -T'0 r CONTRACTOR LICENSE#(REQUIRED): C D�2�(7 CITY OF EVERETr BUSINESS LICENSE#(REQUIRED): �J Z PRIMARY CONTACT: ❑ OWNER )0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 1/Z�- D-Z 7 CONTACT EMAIL: /7 ed'5") ::.BUILDIING.PERMIT %APPLICATION Existing Use of Building: FH ontract Price of Work:$ �Z Proposed Use of Building: eat Source: Mbas ❑Electric []Other Building Type: ❑SFR-Detached ❑SFR Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New E]Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition []Change of Use DESCRIPTION OF WORK: ny � ,//) SM*-ol, I2010( 7,17W D 11v r-/i Cfl i/f7r"J�/�Ll�� 7 �� ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPL.IdAtIO.N PLUMBING PERMIT.APPLICATION Type of Project; _New _ Addn _Alteration _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/Mopletc.) Other: SP➢ZI.N-KI.EI2/ 3U P0RtSS.f0N.SYSTEM_ Number of Heads ACKNOWLEDGEMENT:l 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 Oficial 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent Signature rte (Revised 5/0/2096)