2921 13TH ST 2017-08-02 - Laserfiche WebLink

PERMIT APPLICA710N Y BUILDING / MECHANICAL/ PLUMBING / SIGN r5F'RINaCLER/ 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 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION � PROJECT SITE ADDRESS: G L] Z � �. �`�,iti'`l�i��QI�' �� .�� PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: � � {p�e�.�--�--� s TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srReer � � f� � � CITY „� STATE - � ZI � OWNER PHONE: Z.� �Z�j�{i - L OWNER EMAIL: : p�? I , .i� L CONTRACTOR NAME: � � '' �j •.,,, (�� CONTRACTOR ADDRESS: srReeT � 3 �1�.�I�In �'- N CITY �G}-� - �� STATE �� ZIP ��L CONTRACTOR PHONE: 7 - �� ' CONTRACTOR EMAIL: ,>�r L� i � CONTRACTOR LICENSE#(REQUIRED): - G�-( � ��Z�Z CITY OF EVERETT BUSINESS LICENSE#(REQUI D): PRIMARY CONTACT: "�-OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) CONTACT N/�ME: CONTACT PHONE: � l (�t� � � 1 � c.f� � �{��-W l� � �;,�;� CONTACT EMAIL: h ^ � vvr� `tv.- BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ �5��, o� Proposed Use of Building: Heat Source: ❑Gas �lElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached uplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: WI�� Y��e� � -�. ��v�-�- 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 #�f List of Fixtures #�f List of Fi�rtures #of Lisf of Fixiures Fixtures Fixfures Fixtures Fi�ttures 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: V Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: � SPRINKLER/SUPPRESSIOfd SYSTEM Chemical or Water No. of Heads ACKNOWLEDGEMENT:I have�eviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit musf comply with currenf federal,state,and loca!law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be aufhorized in writing from the Building Official before being authorized under any circumstance.1 am tire owner,or I am authorized by the owner of this property to perform the work for whrch application is made, and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use On/y ' Z 3 r P T# O � Ol � Owner/Authorized Agent Si ure Date (Revised 9/23/2016)