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2528 E GRAND AVE 2017-08-10
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2528 E GRAND AVE 2017-08-10
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Last modified
8/10/2017 3:42:24 PM
Creation date
8/10/2017 3:42:18 PM
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Address Document
Street Name
E GRAND AVE
Street Number
2528
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PERMIT APPLICATI• <br /> GUILD& I MECHANICAL I PLUMBING I SIGN I SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Else or Black Ink Only 'lease) PROJECT SITE IN FORMLaTUON <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION _ <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET JA 4 1�-?VkT <br /> CITY .(/ �' J STATE &-1114 ZIP <br /> OWNER PHONE: 2)`T .-1 z 5- OWNER EMAIL: ��� �� �"�(,) �,� <br /> CONTRACTOR NAME: /lI <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: gtOWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: "r- <br /> ,L r X CONTACT EMAIL: 44 <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Ak5,,aew�F L Contract Price of Work:$ <br /> Proposed Use of Building: n-Ig - Heat Source: ' Gas []Electric []Other <br /> Building Type: SFR-Detached ❑SFR-Attached ❑Duplex []Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition EIRemodel XRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: /l7� �Al 7-"V771-4`- <br /> Jtd p p'K a /��-/ `ar�2 t�/ XN�4 cc S; y'tr'Y�YT /�R etc ,3y4 SBntcr r AD /'i-rr/1� <br /> i7�'r iN' 41X22 5 iAJ �'�5�:��U;. �i.J.;c�S i �/Z q ��u i✓�� t�,t,,odY� s�ti'�+ls ��,� &EAU <br /> '7-a. �W4iA,/. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn _Alteration _Repair Type of Project: _New Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet A 711 G Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler J Lavatory(Wash Basin) Drinking Fountain <br /> / Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT./have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> current federal,state,and locallaw.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.1 am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 co ly wi7 he State Contra 18.27 RCW and 296.200A WAC. <br /> �--� City of Everett Official Use Only <br /> PERMIT <br /> O r Authoriz d Agent Signature Date (Revised 512.012016) <br />
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