2205 BROADWAY 2017-10-03 - Laserfiche WebLink

ERMIT APPLICATION BUILDIN 00'ECHANICAPLUMBING / SIGNWRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVI 3200 CEDAR STREET,EVERETT,WA 98201 OL (P)425-257-8810 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: �20A�t� PROPERTY TAX#: OQ43914� ex�tO� LEGAL for new construction: Short Platisubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: W 1NL6&z56-►-,S Cp TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET 10(,p if 'tT Qd /ys -#t7/&4-o CITY STATE /L- ZIP 6,001-5 OWNER PHONE: } ��s. �IL, OWNER EMAIL: THDMP�S W 1LSC�P— WZ�L(a+eE�S_ Corr CONTRACTOR NAME; CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: / CONTRACTOR LICENSE##(REQUIRED): f fC1- I90,'l _!9S 4C ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 'j S PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION �xisting Use of Building: - Contract Price of Work:$ 'roposed Use of Building: tjp 6 Heat Source: ❑Gas ❑Electric ❑Other 3uilding Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: %Commercial [Industrial Type of Project: []New ❑Addition gRemodel ❑Repair ❑T.I. ❑Sign []Sprinkler ❑Demolition []Change of Use )ESCRIPTION OF WORK: IA37Ekjo2 Q©vOJ19'f1onJ 'fz5 �orl STMT 2 PR-(VA'f67 �c�r'Jvt7 �+aoM3 P 4JHccxT, �D 'r}}C Phtfl�W1/iLY N� E?(�>2/O'2 02 �IT� 1��2f1 /.f /N TNS S�O� d'IG GcX)�, 4SSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION hype 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 Fixture Fixtures A/C—Air Handling Units I Heat Pump504/r- Sackflow Preventer(Inside Bldg) Forced Air Systems Unit Heater> Bathtub Urinal Gas Piping Boiler -Z- Lavatory(Wash Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink& posal Grease Trap Gas Range Z Ducting Dishwasher oof Drains Clothes Dryer Hookups Other: Clothes asher Me I Gas Range Hood Wat eater Other: Exhaust Fan (Service/Bar/Mop/etc.;i Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads ICKNOWLEDGEMENT.•I have reviewed this application and contrrm the information contained herein is true and correct. Work done pursuant to this permit must comply with urrent 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 Wilding 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, ,nd I comply with the State Contractors Law 18.27 RC and 296.200A WAC. City of Everett Oficial Use Only PERMIT# �(•l3. 2a l cA M )w Aut orized Agent Signature Date (Revised 10/12✓2015)