2422 73RD ST SE 2017-06-07 - Laserfiche WebLink

i PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING it SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 OL (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov wwv.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: c2q Q Q —73'� fr-�n— (Sr PROPERTY TAX#: (DQS /OQO D DO LEGAL for neve construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: `T — ' adENANT NAME(If Comrnercial): OWNER MAILING ADDRESS: STREET �'/9�6 jig/ �/NC- CITY �� CITY lei( tkf+.-A-�"T f`i`t-) T,..'"f �� 71F OWNER PHONE: /J A OWNER EMAIL: iiJ A CONTRACTOR NAME Inc,. CONTRACTOR ADDRESS: STREET /7&�/Z't/ �� CITY tY. V j/1 t STATE WT ZIP CONTRACTOR PHONE: '�j�e��j=''%Q'y--0M CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REOUIRED): CDie/Vr C_r 71166 1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) .. CONTACT NAME: CONTACT PHONE: C RA-1 G Vr'r s E R- CONTACT EMAIL: Oyu' Cgy? -yam c6,•l t BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: s s '7 08-UQ Proposes!Use of Building /t Heat Source: ❑Gas ❑Electric ❑Other Building Type: ClRI�FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel 9364air ❑T.I. ❑Sign ❑Sprinkler ODemolition ❑Change of Use DESCRIPTION OF WORK: 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 Iof List of Fixtures #of List of Fixtures #of List of Fixtures #ofList of 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: j Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: 1 SPRINKLER I SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT.f have reviewed this application and confirm the information conlained 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 f am the owner,or t am authorized by the owner of this property to perform the work for which application is made, and f comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMI 0wvnerf uthorized Agent Signature Da� (Revised 5t2012014) l