5013 ELM ST 2017-10-18 - Laserfiche WebLink

• PERMIT APPLICATIO10 BUILDIN / 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/permit (Blue or Black Ink Only Please) PROJECT ITE 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: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY Ev ere-4 STATE We, ZIP OWNER PHONE: l�J - i� t OWNER EMAIL: CONTRACTOR NAME: yyrr LLL CONTRACTOR ADDRESS: STREET b (p-h Av Lo -F�-jL CITY � -^� 66STATE ZIP CONTRACTOR PHONE: G42.5-�j 1 p 1 � �c1 CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): VCITY OF EVERETT BUSINES LICENSE#(REQUIR t PRIMARY CONTACT: ❑ OWNER WCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 261 _ -72VOct CONTACT EMAIL: BUILDING PERMIT APPLICATI Existing Use of Building 0t✓ ' �trjc'L TFC&ItLA Contract Price of or .$ bo Proposed Use of Building: V J I Heat Source: s ❑Electric ❑Other Building Type: ❑SFR-Detached 3KSFR-Attached ❑Duplex ❑Multi-Family-#of U ts: C}Commercial ❑Industrial Type of Project: []New ❑Addition []Remodel []Repair ❑T.I. ❑Sign ❑Spri r olitio []Change of Use DESCRIPTION OF WORK: 1 �t 9 t rry o,-- meAw An> RX!.Cv, 0 v V)cL - 16>5Q13"'r'""Y 1S - bt' CMt/ TIJ�p � �� ASSOCIATED BUILDING PERMIT#(if applicable): A t\ C 1 --Vl Aur,-, a,,e -TL,6e 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 was Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater 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 q L —J ACKNOWLEDGEMENT/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. City of Everett Official Use Only L", /'�' �' 0 9 — Own Au orized ffgent Signature Date (Revised 5/20/2016)