805 GRAND AVE 2017-05-23 - Laserfiche WebLink

PERMIT APPLICATION K '�( � C) BUILDII` MECHANICAL/ PLUMBING / SIGN RINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVIGLJ 3200 CEDAR STREET,EVERETT,WA 98201 OL (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: � PROPERTY TAX#: LEGAL for new construction: Short Plattsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: V` TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITYr-- STATE ZIP OWNER PHONE: Z F - ' _ OWNER EMAIL: CONTRACTOR NAME: SL C(Z� CONTRACTOR ADDRESS: STREET CIN C + STATE ZIP CONTRACTOR PHONE: —270. Cj CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED):T3 J CITY OF EVERETT BUSINESS LICENSE#(REQ RED):(J l PRIMARY CONTACT: ❑ OWNER ACONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: (2 l; catn BUILDING PERMIT APPLICATION_, Existing Use of Building: Contract Price of ork:$ Proposed Use of Building: Heat Source: ❑Gas �L3ther """"Y Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair [IT.]. []Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: c vi " ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New_ Addn _Alteration X,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 7 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/SUPPRESSION SYSTEM Chemical or Water I I No. 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 Official before being authorized under any circumstance.l am the owner, or l am authorized by the owner of this property to perform the work for which application is made, and/comply wit e State ntractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only P�nR�IT# -Z77 qc X22- er/ th zed Agent Signature Date (Revised 9/23/2016)