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4531 SEAHURST AVE 2018-01-04
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4531 SEAHURST AVE 2018-01-04
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1/4/2018 3:42:55 PM
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1/4/2018 3:42:54 PM
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Address Document
Street Name
SEAHURST AVE
Street Number
4531
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• PERMIT APPLICATION• <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 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION` <br /> PROJECT SITE ADDRESS:y 5�J ��� � � PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: \ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTaeer QC(, G <br /> CITY �� STATE ��, ZIP �g� <br /> OWNER PHONE: a ' 02� - L I OWNER EMAIL: f <br /> CONTRACTOR NAME; (3 <br /> CONTRACTOR ADDRESS: sTReEr �/�f � � <br /> cin' i..� STATE ziP <br /> CONTRACTOR PHONE: �I v�Z - 7 7�- CONTRACTOR EMAIL: r(/ O U ` i�'I /'/ <br /> CONTRACTOR LICENSE#(REQUIRED): � CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (�J 7 <br /> PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR �OTHER (Please Specify) � � <br /> CONTACT NAME: �J/,,�� ']����.��,N� CONTACT PHONE: L - r � <br /> �i�� <<J ��� <br /> CONTACT EM/►�' p�� � <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ � <br /> Proposed Use of Building: Heat Source: Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached C'�'�FR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Pro'ect: ❑New ❑Addition ❑Remodel epair ❑T.I. ❑Si n ❑Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: �k � C��� <br /> L� � � �v �,�Vr� f K�^�t/cc.CtG ��G d u- �,voL cc1�f�v`h�it!' <br /> c�iaN°�� o�f . <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 Fixiures #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 <br /> ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and conect. Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of a permit on/y 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.I am the owner,or 1 am authorized by the owner of this property to perform ihe work for which application is made, <br /> and I comply with the State Contracto�s Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT <br /> • // 1 .1 <br /> Owner/Authorized Agent Signature Date (Revised 10 12/2015) <br />
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