6815 MORGAN RD 2017-06-22 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER/ 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@evereftwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only',Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: (R$)S m 0 /J PROPERTY TAX#: 003 933OX0 ) loc) LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: F )XYT(4 (A K5ETENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET SAMC. CITYI STATE ZIP SLAOWNER PHONE: L4 ZS "S� - C!�� OWNER EMAIL: b. , r c M I a-ol ,Cor CONTRACTOR NAME: 0)1ANC[ LNSi f�L LAT1 v�� ( /J C- CONTRACTOR ADDRESS: STREET l Ia I 1-11(D ( CITY LLl N AJ L-)'D STATE ZIP ZIP q 8U3 CONTRACTOR PHONE: �Z� • !S CONTRACTOR EMAIL:a6 v y P QJ vat,ad ; SfrlRAI 1011 ✓. tj- CONTRACTOR LICENSE#(REQUIRED): ADVA/J 13 033 C)b— CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): T�7- PRIMARY CONTACT: ❑OWNER ;ffCONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 2� . YS .Sl�3 �,HHq ' K- S CONTACT EMAIL: PO'dW'rAC-0- S}u/(aficon BUILDING PERMIT APPLICATION �""� Existing Use of Building: Contract Price of ork: $ Proposed Use of Building: Heat Source: ❑Gas a.`_DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex []Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: []New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ASSOCIATED BUILDING PERMIT# if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New Addn X 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 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 Buildin fficial 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 com ly with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Ow erl u! ri d Agent Signature Date (Revised 9x/23/112016) lam\