2608 23RD ST 2017-08-25 - Laserfiche WebLink

PERMIT APPLICATIO BUILDIV/ MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES OL 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 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: .Qboq ,123' �'i ✓��tr i%t,.JJ�.�7y Z)I PROPERTY TAX It: 00 01& J-gt)6)10 U LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) / �1 CONTACT INFORMATION OWNER NAME: GAN A�1 41 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET y%t FR/�/`1// V COY J / STA/TE t^.M ZIP e OWNER PHONE: 6 OWNER EMAIL: L' laLyt�O L'r�/YI CONTRACTOR NAME: A) all CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAiL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: IMOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: f� CONTACT PHONE: 4,6 7/ CONTACT EMAiL: BUILDING PERMIT APPLICATION Existing Use of Building: J 170 lContract Price of work:$ Proposed Use of Building: Heat Source: ❑Gs ❑Electric, ❑Other Building Type: SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial [Industrial Type of Project: ❑New .Addition ORernodel ORepair ❑T.I. ❑Sin ❑Sprinkler ❑Demolition KChange of Use DESCRIPTION OF WORK: Ay�i/I if E?X Z /IIiL- � OD� Gl�ll>' C/71i� F�Lif lj ,wi�7crUv��. ASSOCIATED BUILDING PERMIT# if a icaNe: MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project. ,New _ Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair Fixtures List of Fixtures Fixtures List of Fixtures Ftxtu fes 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 ash Basin Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove lKitchen 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/M etc. Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads I [-� ACKNOWLEDGEMENT:t have reviewed this application and confirm the information conta#ied herein is true and correct.Work done pursuant to this permit must comply with current federal,state,and local law.The grdridng of a pem*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.i am the owner,or i am authorized by the owner of this property to pedorm the work for which application is made, and!oom he Sfafe Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner A ed Agent Signature Dace (Revised 9123/2016)