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5801 23RD DR W ELCON 2017-10-25
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5801 23RD DR W ELCON 2017-10-25
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Last modified
10/25/2017 3:48:30 PM
Creation date
10/25/2017 3:48:28 PM
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Address Document
Street Name
23RD DR W
Street Number
5801
Tenant Name
ELCON
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• PERMIT APPLICATION • <br /> BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2s ' PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: ELCob TENANT NAME(If Commercial): Et –C DN <br /> OWNER MAILING ADDRESS: STREET <br /> CITY'c-V -TF STATE UJA ZIP <br /> OWNER PHONE: '711 S- `,6OWNER EMAIL: <br /> CONTRACTOR NAME: M.'-z-, K ,' <br /> CONTRACTOR ADDRESS: STREET 600 SW .H <br /> CIN STATE ZIP 61- <br /> CONTRACTOR PHONE: y2S Z0-7-OO',�i CONTRACTOR EMAIL: PAVI ' <br /> CONTRACTOR LICENSE#(REQUIRED): ,J?/1G' Z ' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER XCONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> ��✓ RN CONTACT EMAIL: Av'&2r P <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: - iTD' F Contract Price of Work:$ <br /> Proposed Use of Building: (A)AIZE-662 Heat Source: []Gas Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair XT.I. []Sign []Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK:—H,,Hf_ 1N.5-rA��ATi01il <br /> QF SEE <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C–Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number of Heads 771 <br /> ACKNOWLEDGEMENT.1 have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> 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 <br /> Building Official before being authorized under any circumstance./am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 Wand 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> ner/Authorized Agent Signature Date (Revised 9/23/2016) <br /> 1 <br />
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