10305 DAKOTA WAY 2017-08-17 - Laserfiche WebLink

PERMIT APPLICATIO BUILDINC*IECHANICAL/ PLUMBING /SIGN . RINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES OL3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PRtOJE T SITE ADDRESS: _ PROPERTY TAX#: L LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNERNAME: IZ 1s q nj f� 0,7%-e,L_ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET (030' QA1-C>T/k L A CITY (-Ve; STATE LAI ZIP OWNER PHONE: �Z �/ —s j OWNER EMAIL: JP,4✓ ,3AAJ ,, f If 6�Izi ELCw C,j AAA IL,GZ)AA CONTRACTOR NAME: 0L�vt e- (" CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: XOWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: ,2 �—i Contract Price of Work:$ 73 LI 0 0 Proposed Use of Building: I Heat Source: ❑Gas Electric ❑Other Building Type: SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial [Industrial Type of Project: ❑New Addition Remodel ❑Repair ❑T.l. []Sign ❑Sprinkler ❑Demolition []Change of Use DESCRIPTION OF WORK: ��rrf,.�.t C'C,r«c in+C) /:.., co� n u j . r�cJ �J r r ISPL,C 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 #of #of #of Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of 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) Drinking Fountain r lWater Heater lRefrigeration iShower 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: 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.1 am the owner,or l 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/ fi Everett LOfficial Use Only PERMIT# /; J l 0 l /�� I Owner/Authorized Agent Signature Date (Revised 10/12/2015) L/L