10202 MERIDIAN AVE 2017-06-21 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/ MECHANICAL/PLUMBING / SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 )(E)evariatteps@evereltwa.gov( www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 10 2,02, M,Qr'1 di 0-41 Ave, [PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision.........._ _ Lot No, (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET { \o DAtt, `/�!�1� CIN ",-r' �/r^-�C. STATE V tZIP 1 V HCl V OWNER PHONE: , L4 d 3 Lo q OWNER EMAIL: CONTRACTOR NAME He ll''1()6- CONTRACTOR ADDRESS-. STREET 416 � r� CITY STATE W ZIP C ??z-( I CONTRACTOR PHONE:%�50'69 1 CONTRACTOR EMAIL: I+►` GvYtI'l-eatiA . com CONTRACTOR LICENSE#(REQUIRED): C � 1 l t a rY'�V CONTRACTOR CITY OF EVERETT BUSINESS LICENSE#(R€QUIREt7): ZIp PRIMARY CONTACT: ❑OWNER toCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: a Z t m Vlt �{� �� CONTACT EMAIL: +�r�1-t-�1 ��1 Y�ea*i*A �0 M BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas lectric ❑Other Building Type: ASFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel VRepair ❑T.I, ❑Si,n ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Tula Cs- ASSOCIATED BUILDING PERMIT#'lf applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of #of FixtList of Fixtures List of Fixtures #of Llst of Fixtures #of List of Fixtures ures 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 Ran a Ductinq Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Ran a Hood Water Heater Other: Exhaust Fan Sink Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water JNo. 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 ROW and 296.200A WAC. j Cily of Everett Official Use Only PERMIT V �-� pill Owner/Authorized Agent Signature Date (Revised W23/2016)