5401 SUNSET LN 2017-07-17 - Laserfiche WebLink

PERMIT APPLICATION BUILDING i MECHANICAL/ PLUMBING / SIGN /ZMNKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES OL 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) (fPROJECT SITE INFORMATION PROJECT SITE ADDRESS: - `1 L' J`�i✓t 5C�T L/`� �J`�" n.�SZ��S' PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 12G�>: r+ Lv ve, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET �jE}Nv-e CITY STATE ZIP OWNER PHONE: 7 O OWNER EMAIL: Y- CONTRACTOR NAME: CAV%(\ (\I r CONTRACTOR ADDRESS: STREET t) �{ ✓�w rt rrr of A CITY e- STATE ZIP ,g ZG,3 CONTRACTOR PHONE: ;�lU(, SLS/-53Z�`3� CONTRACTOR EMAIL: ) Fw c- I�c'z,>{/amu CONTRACTOR LICENSE#(REQUIRED): ELS KkO 43 ICITY OF EVERETT BUSINESS LICENSE#(REQUI(D): PRIMARY CONTACT: ❑ OWNER aCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: II CONTACT PHONE: j- 397^ brl 3+ I��Y\ Bev �' r11 CONTACTEMAIL: I< ��t'c.l�►�Ottit�[ �tr'�� hSrCvo�n BUILDING PERMIT APPLICATION Existing Use of Building: 2e,; Contract Price of Work:$ r ZEA 0 117 2- Proposed Use of Building: (2e Heat Source: WGas ❑Electric ❑Other Building Type: SFR-Detached ❑SFR-Attached []Duplex []Multi-Family-#of Units: ❑Commercial ❑Industrial Tye of Project: ❑New ❑Addition 5�Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Chan a of Use DESCRIPTION OF WORK: jv15' 11 J ; ,i'pi',-� / I",rv"tc,t--/ 140l wn"IrrN e�L rv- � ASSOCIATED BUILDING PERMIT# if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New 'X Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of 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 lWood Stove lKitchen Sink&Disposal Grease Trap Gas Range Ducting IDishwasher 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 I I 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 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 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT �1 O LJ] Owner/Authorized Agent Signature Date (Revised /23/2016)