2717 GRAND AVE 2017-11-17 - Laserfiche WebLink

4-77 PERMIT APPLICATION BUILDING I 'CHANICAL / PLUMBING / SIGN / SONKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: � 7I 7 � /`L'4/1,71,. } ('. 42PROPERTY TAX#: C/31 1 6' 0 0 q /„ LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: T 1-±; ;va, V u/vtli d I ( TENANT NAME/ 7 (If Commercial):m OWNER MAILING ADDRESS: STREET 9— ‘' i S,.Z /k:,' (1-11 A ` ? jai.; / 6% ") /e `) // 1 CITY ,S/V i.,;A 44:) V•A STATE � G/( (2_ZIP (I.` OWNER PHONE: V) ) - �.2 Vit `? i(r OWNER EMAIL: /3/'t'ivriT p f4/44U /7(> 6:1,14.1-1 ( /'/'1 CONTRACTOR NAME: 0(a 9N.e_eg7 ------ CONTRACTOR —CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ,OTHER(Please Specify) /-6,41 c/)a?/Vi/ CONTACT NAME: CONTACT PHONE: ti j - _yL f e 6/ f , I ( k 8 e/v f/j'6tv CONTACT EMAIL: p/ c k )i ,,,,---t,, Narv' 4 i,/g ; G p,,, BUILDING PERMIT APPLICATION Existing Use of Building: S / !` Contract Price of Work: $ ;->C C 1, Proposed Use of Building: S. r g Heat Source: 6—Gas ❑Electric ❑Other Building Type: ti8FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial - Type of Project: ❑New ❑Addition Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition //❑Change of Use DESCRIPTION OF WORK: Cc AA/ i. .re ✓(-e�:i,e/ A" ti,,-"c.._A- ,S Ft,A ,- . ,474.6 ilii" ✓)kGrwriv-ki 7�7 4l5 '4/,Iit? PD k .uac v--. -( ASSOCIATED BUILDING PERMIT#(if applicable): _ 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 j Bathtub Urinal _ Gas Piping Boiler / Lavatory(Wash Basin) Drinking Fountain - Water Heater Refrigeration Shower Floor Drain _ Gas Fireplace Wood Stove i Kitchen Sink&Disposal Grease Trap / Gas Range ' Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: / Clothes Washer Medical Gas - f Range Hood / Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) I Other:c,L e/?i cit.,,,' b✓f-ri L;Iv..1 SPRINKLER/ SUPPRESSION SYSTEM ^ Chemical or Water I No.of Heads ACKNOWLEDGEMENT:I 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 PERMIT#:-- /Q,�I4,�-/7 ,° 3 - �� Owner/Authori ed Agent Signature Date (Revised,9/23/2016)