2910 16TH ST 2017-06-07 - Laserfiche WebLink

PERMIT APPLICATION BUILDING ECHANICAL/ PLUMBING / SIGN 'RINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICE 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 PROJECT SITE INFORMATION PROJECT SITE ADDRESS:2-9!O / fj STPR ERTT�AX#: UDS 7 Y / 3 2 S a,0S.00 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: e-)qN r3 t4 c { TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 13L4 L) be4 A CITY e el l ev LA-t- STATEW4 ZIP $DUB' OWNER PHONE: L/ZS_9 22- 9'9 7 C OWNER EMAIL: C ego 6 U ehana n A-DL• C4vv-) CONTRACTOR NAME: Ouwr CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: DOWNER 11CONTRACTOR ElOTHER(Please Specify) CONTACT NAME: fya( f1 33Ue,ho-VlO-n CONTACT PHONE: t42-T^q 2_Z -S S?,cj CONTACT EMAIL:(�lCt y1 h U�h�1�ll1 �J pi-01- BUILDING pLBUILDING PERMIT APPLICATION Existing Use of Building: S( l L MYl i l 0-tS l(,Xl tA- Contract Price of Work: $ 4491 000 Proposed Use of Building:S i'1 l,L dZLS iCl LY1[� Heat Source: ❑Gas EkETectric ❑Other Building Type: EGFR-Detached ❑SFR-Attached ❑Duplex []Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: El New ❑Addition remodel EKepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Q L)m pLC�C_ PS-VaLy- "4�5f -L tlrxtv- <-I pUr 0 Y cel rtaGly SVek-,ir-deo V-k-OVA LJL nC do rcp t c f r-t_joac:, +ttvvACk LCw�nc!vWs t w�rUy�. W J Ci el d Z- b 0-4-4;1 rC.f`v&J cb ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New Addn Alteration ZRepair Type of Project: _New _Addn %/Alteration \"Repair Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #of List of 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 J Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT:t 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 wider 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# (112 1 ( � I Owner Auth ize Agent Signature Date (Revised 10/12/2015)