2131 BAKER AVE 2017-08-08 - Laserfiche WebLink

PERMIT APPLICATIO BUILDINOMECHANICAL/ PLUMBING / SIGN / PRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 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) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: :"/ �, PROPERTY TAX#: U0.5f- LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: �i' ,7 /�ij�//� �t' (�t TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET ,2/' >/ CITY " STATE j�;_!j2 ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET cnY STATE ZIP CONTRACTOR PHONE: EMAIL: (- ', , e- CONTRACTOR LICENSE#(REQU D): 2—L S l'1 bLJ9114YOF EVERETT BUSINESS LICENSE#(REQUIRED),j�I )d r PRIMARY CONTACT: ❑OWNER EICONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:�J CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ t o Proposed Use of Building: Heat Source: ❑"Gas ❑Electric ❑Oth6r Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition 13Remodel ❑Repair ❑T.I. ❑Sign []Sprinkler ❑Demolition ❑Chan e of Use DESCRIPTION OF WORK: <<GGv7C20L > i UJVFii�,�rTL� �- En i L�law- >b /r�c�ddx �vrr1i✓y of �,IcT�n�r w5, /XEi.� O,ry�rfi�,v ra � eiTi=r� fy/5/fE0 t GNf/N/tN'E� ids o� p�,��E/vT � fivi�6if5 / 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 Lavatory(Wash Basin) r Drinking Fountain Water Heater Refrigeration Shower loor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookupf 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: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.l 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 IT 4), f 7 ;Ike \G C � �— 0��2 :1 Owner/Authorized Agent Signature Date (Revised 5/20/2016) c��