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802 LAUREL DR 2017-11-17
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802 LAUREL DR 2017-11-17
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11/17/2017 2:18:53 PM
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11/17/2017 2:18:52 PM
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Address Document
Street Name
LAUREL DR
Street Number
802
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4-77- I PERMIT APPLICATIOi <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: (V LCLLCVel i)l PROPERTY TAX#: OO T 3 c d 0' IQ I <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: 1 V/SI7v t -RI'rtrSC� TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET �XO L )_LLVQ./ by-Joe <br /> CITY Ei'e✓etl" STATE kill ZIP el 26 I <br /> OWNER PHONE: L-I-as-- 3L i- -a-1-3(-4: OWNER EMAIL: <br /> CONTRACTOR NAME:-EVA L--- (,01_,C. Okv 1L ( � 1-1 -&1417-1(--- <br /> CONTRACTOR ADDRESS: STREET 1(1(0 �`U-Q 1 \� S�1 1 <br /> CITY /1li it Y 'Laws STATE ViL <br /> ZIP <br /> v' o- <br /> CONTRACTOR PHONE: L0._ • ` A'l3(3\ CONTRACTOR EMAIL: k V T Y A,92./(A Cblk , CONN\ <br /> CONTRACTOR LICENSE#REQUIRED):: 1J- -k )S fc <br /> CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): G-1-3-4---4- <br /> PRIMARY CONTACT: 0 OWNER ///CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: �r-+is_ �S 3\3C,}, 'U,_ <br /> IOV\( GAASOY\ CONTACT EMAIL: 1 CW � 'UscYl (1 1(i' co1YV\`so..A s CS N`Y_ <br /> BUILDING PERMIT APPLICATION t t� <br /> Existing Use of Building:R ZEA (,�� Contract Price of Work:$ `Q \O PC)Proposed Use of B)ding: -9.E._�V\e_- Heat Source: EI/Gas DElectric 0 Other <br /> Building Type: gSF,R-Detached ❑SFR-Attached ❑Duplex 0 Multi-Family-#of Units: 0 Commercial ❑Industrial <br /> Type of Project: 0/New ❑Addition 0 Remodel 0 Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICALRMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn Alteration Repair Type of Project: New _Addn Alteration _Repair <br /> Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #°f List of Fixtures <br /> 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 <br /> 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 <br /> current eral,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 /> fe <br /> Building fficial before being authorized under any circumstance.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> and I.o ply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> r <br /> l l l `L� !()/(4i- PERMIT# 7 <br /> Owner/l itlj'orized Ag fit ignature (Revised 10/12/2015) <br />
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