6825 COLBY AVE 2017-10-04 - Laserfiche WebLink

PERMIT APPLICATICIS BUILDI10/ MECHANICAL I PLUMBING I SIGN77SPRINKLERI DEMOLITION CITY OF EVERETT PERMIT SERVICES 4e7T 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 Biack ink Only Please), 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: V- 01 CaAi5 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET u CITY STATE ZIP " 8 OWNER PHONE: "fZ5 , ' 07(.3 OWNER EMAIL: CONTRACTOR NAME: �! CONTRACTOR ADDRESS: STREET 1 76 Z-5 `'7V 6l fh e W CRY /0'Dev; ) rj STATE j//✓/7 ZIP C/6'0- CONTRACTOR PHONE: W 6"601Y-`i I/q /� (� �1CONTRACTOR EMAIL: r l(/ 7 f / a-IJ� �d Ac f ars CONTRACTOR LICENSE#(REQUIRED): U I /�f� U i�/ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): ! 0,Pe/633 PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: v c I pi C-A-1I CONTACT EMAIL: �� i�-dsf`�► V#I L-Y t`' an8 to, Co.,, BUILDING PERMIT APPLICATION Existing Use of Building: `Sr,J lht,C. )Z",Y—LIId Contract Price of Work: Proposed Use of Building: �fAJ 'L V#YAti t ✓etC f lHeatSource: ❑Gas b$Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New air ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use low DESCRIPT ✓�a v;tc� iS�iMt� ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT.APPLICATION Type of Project: Now _ Addn _Alteration Repair Type of Project: _New _Addn _Alteration Repair #of List of Fixtures #of LhO of Fixtures #of List of Fixtures #of Lisf o fixtures Fixtures Fixtures Fixtures Fixtures A/C it Handling Unitsat Pump Toilet 7sibBackflow P enter(Inside Bldg) ForcedX Systems Unit Heater I Bathtub Urinal Gas Pipin Boiler Lavatory(Wash Ba D ng Fountain Water Heate Refrigeration Shower loor Drain Gas Fireplace J0 Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting i Dishwasher Roof Drains Clothes Dryer H4Wups Other: Clothes Washer al Gas Range Hoodor Water Heaterov Other: Exhaust F Sink(S ar/Mop/etc.) Other: SPIZINALER t SUPPRESSION SYSTEM Number of Heads ACKNOWLED EMENT.•I have review t is application and confirm the info.mation contained herein is true and correct.Work done pursuant to this permit must comply with current feder ,state,and to he anting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Off ial before b 'g auth-rize u er any circumstance.I am the owner,or l am authorized by the owner of this property to perform the work for which application is made, and I c y with the a e Co ract / aw 9 .. RCW and 296.200A WAC. / City of Everett Official Use Only PER # 7—Z(-16 DvWAuthorized Agent ignature Date (Revised 5/20/2096)