1817 RAINIER AVE 2017-06-29 - Laserfiche WebLink

PERMIT APPLICATION BUILDIN(�'IECHANICAL/ PLUMBING / SIGN RINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES � 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: � PROPERTY TAX#: ?�� ,;�.�.z:- t-�� 1S1u1 �C�`G � G� '�'c?� LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: .,r.'� �-,^cs,r>� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReeT �`3 � ��;��;r- �'v`� CITY �rj �. �� STATE �irt. ZIP CJ� ��/, OWNER PHONE: `1Z� �.3�.Z "LJ�c�1`_{ OWNER EMAIL: �vlpC'v T '�'i�f��L�,' �' c; v� �,, � , CONTRACTOR NAME: •-� `; CONTRACTOR ADDRESS: srReeT CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: �OWNER ❑ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: �;L��1�J CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION ,_ Existing Use of Building: y- Contract Price of Work: $ Proposed Use of Building: �r Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial T pe of Project: ❑New ❑Addition ❑Remodel �Repair ❑T.I. ❑Si n ❑Sprinkler ❑Demolition ❑Chan e of Use DESCRIPTIONOFWORK: I��lc;.� �1� c i'.�v,��.-�� i,:��,�°� �p<'7 w� C.��Itit �;,�n � �6=k� �;�;r��_ i �'11 > ��: r � Y�l i_..�'V�� i�C)l 1'T� �1�9'-+i,��` "�'�. Vl i:li`,�+��_i.:R� /i�17�<.J.� �� V�l v J4.s.�-_ �i i, :��,�,�J�• �v ��,��v l;, :1.2-�:`-ti�7 � �'-'�— ��1�l.\C:,�.�u 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 Fi�rtures Fixtures Fixtures A/C-Air Handlin Units Heat Pump ( Toilet Backflow Preventer Inside Bld ) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler q Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove i Kitchen Sink&Disposal Grease Trap Gas Range Ductin Dishwasher Roof Drains Clothes Dryer Hookups Other: j 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 1 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 O�cial Use Only �l '� PERMIT# . ��: � ,�-��.:� , � � � �� - �o� Owner/Authorized Agent Signature Date (Revised 10/12/2015)