6521 EVERGREEN WAY 2017-10-20 - Laserfiche WebLink

05/18/2017 THU 14: 15 FAX FaDt water Heater 0006/006 PERMIT APPLICATION BUILDING /MECHANICAL./PLUMBING / SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVECES 1200 CEDAR STREET,EVERETT,WA 08201 (P)425-257-8870 ( FAX 425-257-8857 I(r=)evnrretlaps®®verattwa.gov I vAvw.everetlwa.gov/permlta Blues ar Black Ink Only Please) PROJECT SITE INFORMATION Q PROJECT SITE ADDRESS: C- PROPERTY TAX#-, LEGAL for new conatruetlon: Short Plat/subdivlrzlon Lot No. (attach copy of long legal desoripllon) CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commerolal)! OWNER MAILING ADDRESS: srgeeTLa 1� crry STATE zl (3a OWNER PHONE: P d- OWNER EMAIL: CONTRACTOR NAME; S 1 CONTRACTOR ADDRESS: 8TREEr 'I I chY Z no t L, BTATE j 21P ` CONTRACTOR PHONE: �p�� r CONTRACTOR EMAIL: EM ff S �-W ArP� , p CONTRACTOR LICENSE#(REQUIRED): S `I 13C CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): �i PRIMARY CONTACT: ❑OWNER gCONTRACTOR D OTHER(Please Specify) CONTACT NAME: 1 CONTACT PHONE: L4 V — CONTACT EMAIL: &I'I-ts BUILDING PERMIT APPLICATION Exlstin Use of BUIIdin : Contract Price of work:$ Proposed Use of Building: bleat Source: Gas ❑Elec!rlc ❑Other Bulfdln a' ❑SFR-Detached ❑SFR,,Attached ODU lex ❑MUltl-Famll -#of Units: Commerclal Dlnduetrla( T e of Pro ect' ONaw ❑Addition ❑Remodel WRepair OT.I. EIGI n ❑S rinkler ODernolitlon ❑Chan a of Use DESCRIPTION OF WORK: jinn Dv�, / r-,O \ ASSOCIATED RUILDING PERMIT# If a Ilcable MECHANICAL P12RMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Projecu ,.New_ Addn Iteration _Repair Type of Project: _New __Addn _Alteratlon Repair 11 of List of Fixtures #of List of Fixtures #of s urea of List of FI e F/xtufaa Fixtures FlYtures Fixtures A/C—Air Handling Units Heat Pump Tollet Backflow Prev er Inside Bid 1J Forced Air Systems Unit Heater Bathtub Urinal Gas Plping Boller Lavatory Wash Basin Drinkl ountaln Water Heats Refrigeration Shouter FI Drain Gas Flre lace Wood Stove Kitchen Sink&DIs osal ease Trap Gas Range Ductln Dishwasher Roftprains Clothes Dryer Hookups Other: Clothes Washer . POI ic Gas Ran a Hood Water Beater er: Sink Service/Bar/ /etc. er: SPRIN 9SSIO 1 3TtM semi t OLV o1 Heads ACKNOWLEDGEMENT'i have reviewed this application and confirm the inrormellon contained herein Is true end correct.Work done pursuent to thls permit must comply with current federal,state,and local low,The grentln®of a permit only aulhadzes approved work and no davlatlono therefrom.Devtallons must llrst he authorized In writing rrom tho Oullding OffWal before being authorized under any olraumstance.I em the owner,or I am euthodzed by the owner of this property to panrorm the work for which application is meds, and l oompiy wllh the Sfata Contractora t,ow 18,27 RCW and 2It8.200A WAG City of Everett Otflclel use Only A LX� s PW S _ o Own uthorzo Ag Signature Date (Rovlsed9123P.20IQj I