1110 BROADWAY 2020-01-21 - Laserfiche WebLink

,, PERMIT APPLICATION �� BUILDING I MECHANICAL/PLUMBING/ ICON/SPRINKL R/®EIL OLIT I®N CITY OF EVERETT PERMIT SERVICES "�� = 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 Gaya gi. ..�..,:.�, v:PR®JE t' ITE. Pti PR AT1€.®ift '_.' N:,: `. ,:__..- ...;:.. ' _.._:._. . _;-_: NN PROJECT SITE ADDRESS: ti i a 23. ._ ___._ PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) gt _ .-_;. ._.'_. F.___ �--'ngasoli:tt9At_H 9A ®90t9fajWgw -_.::; igM-.4��._- ._ ._ ._ .. -. OWNER NAME: � ), //�AtWt-S _LI'L1 s//Mr.1,r/ TENANT NAME(If Commercial): \V� OWNER MAILING ADDRESS: STREET /q go/ 50-it 4Yr (n Cr(Yk/A 1,").0-0C, STATE ZIP'Ye)3- OWNER PHONE: e{"7-.3 '75 C) "711_6 OWNER EMAIL: ie'74 j/0 I /40445/ki lc.. C,c, ' CONTRACTOR NAME: -4kto ee-1,1't'-P°*1 CONTRACTOR ADDRESS: STREET / /g(.)) 5O4.1^ ,�,1Z_ / v j/ / ',Y-C.,--,31‘ CITY / k 44_LJ�c,,C.."( STATE 6V)4 ZIP CONTRACTOR PHONE: 412s '7 S ) '7'7-6 CONTRACTOR EMAIL: ,^ .vela, /%wl.�s/id/Ori'5-7 cz:� CONTRACTOR LICENSE#(REQUIRED):--Ii<1,-) Cje'6 g7_,v S CITY OF EVERL=TT BUSINESS LICENSE#(REQUIRED): 0516/ '3 PRIMARY CONTACT: JZI OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME :::;: NE: X44IL: c.7-i—c____ 1 . ': _._... t__.. .. _ _/`_.*,...i p,wgD,iNCjr PERiykap,FeLi.I ATII:IiI... .. ._. ..: o.j.`.:..., .�....:..:__sf_ '._, = Existing Use of Building: ` t,-3 ? -/ � / /U�c---,� / Contract Price of Work;$Q, '�75 .�Z�lp Proposed Use of Building: '>c z _ Heat Source: Islas Utlectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family #of Units: ^I Commercial Dlndustrial Type of Project: ❑New ©Addition ❑Remodel El Repair Lf.L ❑Sign OSprinkler ElDemolition ❑Change of Use DESCRIPTION OF WORK: f #E // .ems / e,7 C> �e_-- ASSOCIATED BUILDING PERMIT#(if applicable): i iitOVRIPOICO itiat iPilii10_TI_ON_".EN ESPICEEffiffagiiiiiNGApPERM:IT:APPLIICATI®NniMan Type of Project: _New_ Addn Alteration Repair Type of Project: New Addn Alteration ,__,Repair #of List of Fixtures #of List of,. 'ures #of List of Fixtures #°f List of " ures Fixtures Fixtures Fixtures Fixtures /• A/C—Air Handling Units -at Pump `2 Toilet Bac •reventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub . mal �i Gas Piping Boiler -z Lavatory(Wash Basin) Drinking Fountain 1 Water Heater i Refrigeration . Shower Floor Drain Gas Firepla .- Wood Stove i Kitchen Sink&Mpg— Grease Trap Gas R.••e Ducting Dishwasher R of Drains Cl. es Dryer Hookups Other: Clothes W.- er edical G f� / -ange Hood / Water --ater Other: Exhaust Fan Si Service/Bar/Mop/etr J 0th (J" l _<ti,sPIRINnitstn/SUPPRESSi0_ xS effald_.:.s C. i Cef-R 1' ® (Number of Heads '.. ACKNOWLEDGEMENT.-I have reviewed this application and confirm the information contained herein is true and correct.Work d.,a 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.lam the owner,or I am authorized by the owner of this properly to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 29 . 00A WAC. City of Everett Official Use Only ..------ PER 0 op Owner/Authorized Agent Si ature Date (Revised 2/2015) Ti 1 1