5129 HILLTOP RD 2018-01-04 - Laserfiche WebLink

� PERMIT APPLICATION• BUILDING /MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: i� 2 �'� �I I I�'(i.� ��t �y"��'j�' ��-y`� PROPERTY TAX#: Z�iC��t�lC "(�-l>`{ -L,��•�j-��, � ,- LEGAL for new construction: Short PlaVsubdivision Lot No.�_� ��dtta�h copy of long legal description) CONTACT INFORMATION OWNER NAME: �-1L� (_._�_/�,,, TENANT NAME(If Commercial): �'C ''y��i. �'V'�'. ° "T'�" OWNER MAILING ADDRESS: srReer -�.��C,' I L�� v' ��j,-� jE' , S �l`\"tG � _�.: ` CITY j3C�I I C-�V�l,-� STATE �,�'�� Z�p C�� OWNER PHONE: ( �2-� � -��I� —4GCi�" OWNER EMAIL: "��`aVl��.C�t.��l'1 1� ��- �1'lE' . C L��YI CONTRACTOR NAME; C � __T i C�1✓1'1l�'�- �� CONTRACTOR ADDRESS: srReer -�-��5�}�"-1��j'� '�L rY ,� ��/I ��. L��%� . h �\��' ��- f'� �. �� i, CITY 7 �� STATE � l zi�� CONTRACTOR PH6NE-�-�"� I Z��j 1 ��Z S�' CONTRACTOR EMAIL: � � ��C��✓1'�1:1� r,�%l.'CLI�I�-�� C CYVI CONTRACTOR LICENSE#(REQUIRE ):�L� � ZC%�' Z C �' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): �p0� PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR �1 OTHER(Please Specify) ' � ' �� 1,1�1L,'� CONTACT NAME: CONTACT PHONE: �"2 G l' I� � (.�" Zy 1`.J V-1 G'� �l,�l'C�V'= CONTACT EMAI L: ,--�-1`��''lCl G� ' �'I�' �� > "�i'7(c� � C `Y"�'�- BUILDING PERMIT APPLICATION Existin Use of Buildin : `�L� �= '�,'�l-'�_ Contract Price of Work:$ ' � �� - C� Proposed Use of Buildin : (��.l_�-Y,1;�� - Heat Source: Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: Commercial ❑Industrial Type of Project: ❑New ❑Addition Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: � �O��l �� l�V CCri,V� i �`� �C�,��'�%[��f�n S "1 U �. (�C;l.��. �r�' -t l C� i�'- L�C C�C'SS "f Z.; �l r � N �''S `��C,��t��v-, . . �� A �C'� t_i�r� ( D��tti��L� ��'-t°�� L t��r l,i% �: �5 S<<�:�-,� �� 5 I 11. '�G�E _.��1�+�ti`L f'��, ASS CI T D ILDfNG PfRMIT# if a licable): �'�GC�,-vi . MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn Alteration Repair Type of Project: New _Addn _Alteration Repair Fi tures List of Fixtures Fi fures List of Fixtures #�f List of Fixtures #°f List of Fixiures Fixtures Fixtures A/C-Air Handlin Units Heat Pump Toilet Backflow Preventer(Inside Bld ) Forced Air S stems Unit Heater Bathtub Urinal Gas Pipin Boiler Lavato (Wash Basin) Drinkin Fountain Water Heater Refri eration 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 ACKNOWLEDGEMENT:I have reviewed this application and confirm the info�mation contained herein is true and correct.Work done pursuant to this permit must comp/y with current federal,state,and local/aw. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authonzed in writing from the Building Official before being authonzed under any circumstance.I am the owner,or I am authonzed by the owner of this property to pertorm the work for which application is made, and 1 comply with the Stafe Contractors Law 18.27 RCW and 296.200A WAC. � _ City of Everett O�cia/Use Only � PERMIT# � �� - ��o�— o c 3 Owner/Ruthorized Agent Signature Dat (Revised 5/20/2016) �5�,�� I� i.%"�1�� -�- S 1�` .,�� S��`'�-'� � --� � � �