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2616 BAKER AVE 2018-02-01
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2616 BAKER AVE 2018-02-01
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Last modified
2/1/2018 9:01:25 AM
Creation date
1/5/2018 11:07:57 AM
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Address Document
Street Name
BAKER AVE
Street Number
2616
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� PERMIT APPLICATIOR� <br /> • BUILDINC�IECHANICAL / PLUMBING /SIGN#RINKLER/ 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: PROPERTY TAX#: <br /> �6/6 .¢KEK A�/E E�E TT Wh `�820� ooyS'�86o4oaioo <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME; /� S DoNoYkN- �f���rl ER TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTReer�b l� �� K C I� � C <br /> -...��,✓�IN.���E� ET� STATE yv�r' ZIP g SAO I <br /> OWNERPHO E: �1aS- 303 - O�-3 9 � OWNEREMAIL: (�, �R��/"t�l� .i � FlIoNTTe�R .�o�`'� <br /> CONTRACTOR NAME ('� D L u N A �{ L <.O N S7/�L(� T T v N �NG, <br /> CONTRACTOR ADDRESS: sTReer �(�y�a 5 . C• EN i o.J - TS S A-��lA�l-a- P� U- <br /> CITY P�FN TU.v STATE y��� ZIP �9 v s 9 <br /> CONTRACTOR PHONE: K2,s- 2�SS- �-'-11L� CONTRACTOR EMAIL: Q�NdLTE✓�� �U�� NAHL LoNSTRU�T,�UN.GDM <br /> CONTRACTOR LICENSE#(REQUIRED): D�L I-F�1I C �� � R � CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR � OTHER(Please Specify) STRti�Ttc/, /�L F.v G,.Z'N EF�, <br /> CONTACT NAME: CONTACT PHONE: ya S _ ��}g , $Sov <br /> P�' TEf1 I/4-S S A N Z CONTACT EMAIL: CTE(� 1�C lh LsN(n1.�EE R�-�Gi..�-0�'�1 <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: �E s 2 0�,� T=,}i 5 F/� Contract Price of Work: $ - <br /> Proposed Use of Building: �C St D CjN ?'T.4� S`l� 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 ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> 5`rA-�3 Z L1� E EX TST�i- �U 6, Fou,v n�+- T To� W 2 T!+ S,tJ'T�TO f� PAp iE,V� EX'rEP,ZolL 5?f�1-P Fvo?SN6,. <br /> Q��f,vk'i� RooF {luN oF� TO SN FSz Tf�kTTON TILENc.k�. <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 #of #of #of <br /> Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures <<st of 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:1 have reviewed this application and confirm the information contained he�ein 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.1 am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made `� <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. `���� <br /> City of Everett Official Use Only <br /> PERMI�n# �. '`} <br /> �.µ- ,,,,, �,,.� t ��/S �!;�` I L,-��� � <br /> nerlAuthorized Agent Signature Date (Revised 10/12/2015) <br />
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