1316 W MUKILTEO BLVD 2017-06-22 - Laserfiche WebLink

I 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 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: I 1-nukibk.o Q I yoe PROPERTY TAX#: DCd-0d-'7 DDD DD 'yD3 LEGAL for new construction: Short Plat/subdivision __Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: L u V TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CIN STATE ZIP AlbOWNER PHONE: OWNER EMAIL: . CONTRACTOR NAME CONTRACTOR ADDRESS: STREET /`7 ry i-t �jE Ib1 g CIN 7kk STATE "' ZIP CONTRACTOR PHONE: `� , --�j��'j D�� CONTRACTOR EMAIL: }j�A CA �7fys1 {�'l� //V[�. G6rY1 CONTRACTOR LICENSE#(RELIUIRED)t GORIVE�P-Z-02 2 L^m CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): O 3 ,5-6 PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: /476 C�JS�� CONTACT EMAIL: Ci2i41 @NiS7i lt� /NG• GByYL, BUILDING PERMIT APPLICATION e Existing Use of Building: cSFR 40k Contract Price of Work: $ / So, 00 Proposed Use of Building S Heat Source: []Gas ❑Electric ❑Other Building Type: 5?;FR-Detached ❑SFR-Attached El Duplex ❑Multi-Family-#of Units ❑Commercial ❑Industrial Type of Project: []New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Si_n []Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: i t ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION i 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 fShower 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(ServicelBar/Mopietc.) Other SPRINKLER / SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT:t 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 t am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and/comply with the State Contractors Law 18 27 RCW and 296.200A WAC. City of Everett Official Use Only ~y PERMIT + IJl f Owner/Authorized Agent Signature ate (Revised 5120/2016)