5610 WEST DR 2017-07-28 - Laserfiche WebLink

PERMIT APPLICA1 BUILDING/ MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 OL (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 5,610uv e-S T or PROPERTY TAX#:00(4 71-7 O()()v Ll 7U3 LEGAL for new construction: Short Plat/subdivision 141 'l'NAG( PC re Lot No. 4/ 7 (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: it LrA i-SUn Z i T TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET S6 lL WeS i D'- /� p CITY ��LK'.� STATE OA ZIP lO2C73 OWNER PHONE: )-5- 35-7 1OWNER EMAIL: CONTRACTOR NAME: scCoA{fA CIrQrS CONTRACTOR ADDRESS: STREET U CITY u*-ft f'}- STATE A ZIP ' Z�'3 CONTRACTOR PHONE: 40-S 8Z67141 CONTRACTOR EMAIL: Ste11arPr0P },e5J e- Cv CONTRACTOR LICENSE#(REQUIRED): SO 0 0 C L 9S i K Q ICITY OF EVERETT BUSINESS LICENSE#(REQ ED PRIMARY CONTACT: ❑OWNER R[CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: '-I Z S-• 870- 72-0 7 eCONTACT EMAIL: S{e-lIAr P;o Pir4;e S � �, C6lAd (-ASS. iV BUILDING PERMIT APPLICATION Existing Use of Building: 5RZ Contract Price of Work:$ 8a 0 '" o Proposed Use of Building: S F 2 I Heat Source: ❑Gas CdElectric ❑Other Building Type: XSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition bQRennodel []Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: P n,SIS -b Rse+r..,,.T A" 01t0 i.:v...3 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 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 1 Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace - Wood Stove JKitchen 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 Number of Heads ACKNOWLEDGEMENT:l 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 Contr w 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT Owner/Authorized Agent Signature Date (Revised 5/20/2016)