518 LEGION DR 2017-06-13 - Laserfiche WebLink

PERMIT APPLICATIO BUILDIN(�ECHANICAL/ PLUMBING / SIGN IRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES OL 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: f Q I ��ON PROPERTY TAX#: (00j/q.7/00006300 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: R e etc IS rd_ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET L{� CITYJ a`V-p STATE W`A-_ ZIP Z� y OWNER PHONE: -7(110 S O OWNER EMAIL: c L_),/A t '�, CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET C4 J 2 n't . I k/ CITY 1..--Ck ti �tiv v(� STATE WCL CL ZIP CONTRACTOR PHONE: Ll 2 � (� CONTRACTOR EMAIL: Sh e yytGt_ ?e-r v-4C (!-6)411 CONTRACTOR LICENSE#(REQUIRED):5 j-j E R1�= t�S CITY OF EVERETT BUSINESS LICENSE#(REQUI E ):7 7 ` 7 y PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: z _ 2-4 L( L( S Co CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: *,re-f>'., e \ L Contract Price of Work:$ G� Proposed Use of Building: e 5, , ,. cL-Q S Heat Source: ❑Gas lectric ❑Other Building Type: SFR-Detached ❑SFR-Attached El Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition Xemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition []Change of Use DESCRIPTION OF WORK: Qt AC� rte'.'� (J�- her c, ,,•� �,,� (�cs�-t �,� 0 4 cJ� ; <�+ U• 6—maOf 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 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# —� Owner/Authorized Agent Signature Date (Revised 10/1212015) Z