1431 GRAND AVE 2017-05-24 - Laserfiche WebLink

PERMIT APPLICATIC'_' / BUILDIN§ I MECHANICAL / PLUMBING / SIGrrSPRINKLER/ 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: 1431 Grand Ave PROPERTY TAX#: 00475329501500 LEGAL for new construction: Short Plat/subdivision see attached Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Richard FOrtmann TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1431 Grand Ave CITY Everett STATE WA zip 98201 OWNER PHONE: 360-387-1161 OWNER EMAIL: CONTRACTOR NAME: Sundance Energy Services CONTRACTOR ADDRESS: STREET 224 192nd St SW CITY Bothell STATE WA zip 98012 CONTRACTOR PHONE: 425-481-9660 CONTRACTOR EMAIL: sundanceenergy1 msn.com CONTRACTOR LICENSE#(REQUIRED): sundaesO63f9 ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED):32052 PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: SFR Contract Price of Work: $3340 Proposed Use of Building: SFR Heat Source: V]Gas 11 Electric El Other Building Type: ❑SFR-Detached VISFR-Attached El Duplex []Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: El New ❑Addition 0Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition []Change of Use DESCRIPTION OF WORK: Installing a gas fireplce stove ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION 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 1 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 Number of Heads 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 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 t comply ith the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# AA Owner/ uthori Agent Signature Date (Revised /23/2016)