1907 CHESTNUT ST 2017-06-09 - Laserfiche WebLink

PERMIT APPLICATION BUILDING I MECHANICAL I PLUMBING I SIGN I SPRINKLER/ DEMOLITION 4e7T 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 I(Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: C) Tn�-( PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATIOM OWNER NAME: �/� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3 A C� �+� y e- CITY C- (J �'p STATE I%_A ZIP 912,0(" OWNER PHONE: �� (� ^ ��r OWNER EMAIL: Zcs Yxfy vA '', (A14 CONTRACTOR NAME: t c;- Cs G CONTRACTOR ADDRESS: STREET pZa r 4 S-I- se, CITY GL c 1I�, STATE A ZIP C Y 3 2- CONTRACTOR PHONE:a 53 - 1-1-7 3- QI j CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): AT6:5eZLg�S �U CITY OF EVERETT BUSINESS LICENSE#(REQ IRED): PRIMARY CONTACT: ❑OWNER OdCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 03 S CONTACT EMAIL: L trlt i S \i lJ��eS 1`""C' L-G BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$�7 0001 00 Proposed Use of Building: Heat Source: []Gas []Electric []Other Building Type: SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair [IT.1. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ASSOCIATED BUILDING PERMIT#(if applicable): MECNAHRCAL 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 AIC-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/Mop/etc.) Other: SPRINKLER / SUPPRESSlON SYSTEM Chemical or Water No. 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 I comply with the State Contractors Law 98.27 RCW and 296.200A WAC. City of Everett Official Use Only V —,� PE Z# D MZ. I caner/ horized Agent Signature Date (Revised 9/23/2096)