2925 13TH ST 2017-08-02 - Laserfiche WebLink

��a�s�ea��'c�rior• �ui��o�� , ��c��sc��.� ��u�d�i�� si��v , v� tai��r�� o�s�to�v CITY OF EVLRETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits (�laae or�lac�s le��r��y �leas�) ��9L�C��'��'� �b�F��tVd��'��i�9 PROJECT SJTE ADDRESS: ��j Z�� l . r °�� r�--}�'i-(,��,�? ��' 'L�' PROPERTY TAX#: ;y=- LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ��d�'A�`�' 1�9��1i14`�O�Bd OWNER NAME: � � ��'j')lZ;r`��-�_S TEIVANT IVAME(If Commercial): OWfVER MAILWG ADDRESS: sTRtEr l L � ?�� ., � ,� � CITY . ,.� � STATE p�a ZI � �� OWPIER PHONE: Z.� �7�j�i - �- � OWIJER EIVIAIL: ��[� ) , �r.% G CONTRACTOR NAME: � � ' uV•� 'r �-t� CONTRACTOR ADDRESS: sTaEET � 3 ��L,�%L�� (�� - (�/`,,� r c -> CITY �'�y� J�-j�� Sl'ATE ��,� ZIP � � / CONTRACTOR PHONE: � .0 C7 S� �,1j �j j CONTRACTOR EMAIL: � � .,J ' ;,�s,.s L� , �� CONTRACTOR LICENSE#(REQUIRED): - �t-f(J S �J L Z CITY OF EVERETT BUSINESS LICENSE#(REQUIR ): PRIMARY CONTACT: "�}OWNER ❑CONTRACTOR ❑OTHER(Please Specify) � I CONTACT N ME: CONTACT PHONE: �� 6� '� .�� `_ � = ��`��}J�'� � � �;,�;7 CONTACTEMAIL: r' � 1 � s, L...% � !v� `t v., �O BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 15�� Proposed Use of Building: Heat Source: ❑Gas l7Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached " C�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: W��'�Y� I"1�1��, -� -�'� I�I�U� ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PL4JMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of Lisf of Fixfures #of List of Fixfures #�f List of Fixfures #°f Lisf of Fixtures Fi�ctures Fi�ctures Fixtures Fixfures 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 Foun.tain Wafer Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clofhes Washer Medical Gas Range Hood Water Heater Other: 1 � 'V Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: � SPIt1IdF4LER/ SUPPI2ES�101d Sl(STEM Chemical or Water No. 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 canply with current federal,sfate,and local lav✓.The granting oi a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Officral before being autho�ized under any circumstance.1 am the owner,or l am authorized by the owner of this properfy to pertorm the work for which applicatron is made, and l comply�vrfh the Sfafe Contractors Law 18.27 RCW and 296.200A WAC. ,� City of Everett Official Use Only Z7 _r PE�I�S ' O1 Owner/Authorized Agent Sifj re Date (Revised 9/23/2016)