3823 HOYT AVE 2017-06-13 - Laserfiche WebLink

PERMIT APPLICATIC BUILDING / MECHANICAL/ PLUMBING I SIGN I SPRINKLER/ 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 luck Only Please) PROJECT SITE 11MIFORMATION �*J PROJECT SITE ADDRESS: ,3623 1 4-,r- — py ;;_ t-4 '99a PROPERTY TAX#: OaLl J/ P J v P LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMA T ION OWNER NAME: D ��'n .�h TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET ® ��L ►� CITYr...� STATE �1�/nj ZIP OWNER PHONE: ��LS— 7 7 OWNER EMAIL: CONTRACTOR NAME: -'J-6Z 1' CONTRACTOR ADDRESS: STREET 37A ' 1h O 57- S�j J- L I �y CITY 11✓ �STATE , ZIP % ZZI CONTRACTOR PHONE: yL�— 8�� CONTRACTOR EMAIL: h CONTRACTOR LICENSE#(REQUIRED): _J762 �¢�/►�I CITY OF EVERETT BU INESS LICENSE#(REQ IRED): PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: -1-O.SC h 2hw r„i ►�ej BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas []Electric []Other Building Type: ❑SFR-Detached ❑SFR-Attached @Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New OAddition ❑Remodel ❑Repair ❑T.I. ❑Sign []Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: �hsevlDt/ �5'fiE'�°T ✓fJG� ;�Z��i� D�i'B✓ ��p�✓ i v,"+^-�� r/Jal, Coy �i Gdr r7ei ASSOCIATED BUILDING PERMIT#(if applicable): / MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn Alteration _Repair Type of Project: New ___,A don _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 1 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: SPRIMMLER 1 SUPPRESSION SYSTEM Number 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 will 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 PF:PAA1 abw -� ICpD D O Authorized Agent Signature Date (Revised 5/20/2016)