1131 RAINIER AVE 2017-06-29 - Laserfiche WebLink

PERr�rr�,PP�ic�riona BUILDI� rV1ECHANIC,4L/ PLUMBING /SIGN RINKLER/ DEIVlOL1TION CITY OF EVERETT PERMIT SERVICE� 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits (Blue or�lack Ink Only Please) PROJECT SIT� IWFORM�7'IOId � ROJECT SITE ADDRESS: ( � 7j I �#} )�}e; �'`� ��/�� PROPERTY TAX#: �� ,, ��(y�� LEGAL for new construction: Short Piat/subdivision Lot No. (attach copy of long legal description) CORJTACT IFJFORMAY'IOM � OWNER NAME: C.� ��i �'�US f d-fG �L.�Q� - TENANT NAME(If Commercial): �f�F}- 5�IJ1 U�' �-�Ul�i �(x 1 � OWNER MAILING ADDRESS: sTREET � � `l �Q f�j'� ` �1 CITY ��A�_� � � STATE �J � ZIP � U �`�� �OWNER PHONE: P'�Z� Z�'�j' •- � (�� lb OWNER EMAIL: �� }✓� �� - � G>�^ _.._ . . _ _ :.,. __, . ._. .. . _. _ _._._ _ _ ... _ , _, .... ......_. .. . . _ . _.., . CONTRACTOR NAME: �'tp�L,r- ,� C t�-,r` p,^ r.�� -F e r-�C '� �- �,L'. CONTRACTOR ADDRESS: sTREET � Q S 9�, ' �' ST S j � I S �C� �j G� t Z.�o I CITY S=,� � � STATE W� ZIP ( '7 Z.�b � CONTRACTOR PHONE �� kjU� � �V��U CONTRACTOR EMAIL: �'�'lt��,�C k�r- ' �^- �- ,. CO:'4'v CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ��t-. 4�`2 �� ,�{-}� � � }U �L� � CONTACT EMAIL: � �. ��-� BUILDING PERMIT APPLICATION � , � Existing Use of Building: Contract Price of Work:$ � ' �i 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 ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: C��e -��;; � c,�r,u A�`c�t�� :�.�..�s�r�'1.��; "�� 3�''�w Za ��'��-� s L�3 � . � ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Aiteration _Repair #of List of Fintures #�f List of Fixtures #of List of Fixfures #°f 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/SUPPRESSIOM SYSTEM Number of Heads ACKNOWLEDGEMENT I have reviewed this applicafion and confirm the information confained herein is true and correct. Work done pursuant fo this permif must comply wifh 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 8uilding O�cia!before being authorized under any circumstance.l am the owne�o�1 am authorized by the owner of thrs property to perform the work for which application is made, ' and!comply with the State Contractors Law 1827 RCW and 296.200A WAC. City of Everett Official Use Only j PERMIT# % / Z �� / �o t(a�vZ- � 2b OwnedAuthorized Agenf Signature Date (Revised 5/20/2016) "� i � ��7/ `�,_._,