5510 OCEAN AVE 2017-09-08 - Laserfiche WebLink

PERMIT APPLICATION BUILDINIIJIECHANICAL/ PLUMBING /SIGNORINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 4e7T 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: CI! VI iL2 f Ct SGTENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET �S/Q C 0-Q— /-{ i) �j7c�/� CITY t � STATE LJ V4 zip l(J-Co -3 OWNER PHONE:' T7 4 — 7 Z0 1OWNER EMAIL: CONTRACTOR NAME: /t jr v'7 CONTRACTOR ADDRESS: STREET CITY �,� t/(� (5 v l STATE zip L! 2-`10 CONTRACTOR PHONE: Z-S --LJ — ILI 3,31 CONTRACTOR EMAIL: a y/I-C ✓YlC( . c,a--k- CONTRACTOR LICENSE#(REQUIRED): A-X LL N C )� 10 I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): �7 PRIMARY CONTACT: RrOWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: I CONTACT PHONE: - 2--7 Lf — -7f7/Z �..Jj c( S'p7, ( � �� CONTACT EMAIL: h kD r U CM'q r 6't✓�n BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: I Heat Source: ❑Gas El Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DES`CCRIPTION OF WORK: Ii ASSOCIATED BUILDING PERMIT#(if applicable): I' 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) Drinking Fountain Water Heater 1 Refrigeration Shower 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.I 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. Qz City of Everett Official Use Only j ,�,�, �l ✓�� kV, J1 3/l � . PERMIT# 1 �✓ Owner/Authorized Agent Signature Date 11 (Revised 10/12/2015)