9031 EVERGREEN WAY 2018-01-08 - Laserfiche WebLink

. • ' PERMIT APPL.ICATION BUII..DING/MECHANICAL/ PLUMBING I S[GN/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� wv�nv.everettwa.gov/perrnits PFtOJECT Sl'TE INFORMATION _ _ __. _ .. _. _ _ PR�JECT SITE A�DRESS: PROPERTY TAX#: U / L✓�.`c ��rr.l W;;t. � LEGAL for new consfruction: Short PlaUsubdivision Lot No. (attach copy of long legal description) i ` - CONT_ACT INFORMATION � OWNER NAME: >c � I � i TENANT NAME If Commercial : � �� c� Cs- e.- ( ) i OWNER MAILING ADDRESS: sTReEr (�;�.- ; �� 7 !�. z z Y 7' O j ! L v c':' �^ t'�'1 w� I CITY C J t'.^ 2�� STATE �^�+ .��T ZIP � s��' OWNER PHONE: 't�2 c- � y 7_ f$ �-F � OWNER EMAIL: c� •' ° � C � - z z ct �jt c �:^��: �� C�•"� __ _ _ _ . —_ . _ CONTRACTOR NAME: z - e��1 . P l �-i �•-r D � �� CONTRACTORADDRESS: sTReer (� f L- � t�� '�- �_L, II CITY BE �t!�� , STATE i'� /T 71P �U � � � CONTRACTOR PHOAlE: �-{ .7? y - E ��CG v�,�U f CONTRACTOR EMAIL: l C: Z.�c-�1 �/4,vy�j• •�� CJc a-+c:. I, c�,to^� ! CONTRACTOR LICENSE#(REQUIRED): Z J!J Pl�C ,�✓E�./'�1 Z CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):O��'/'E 7 '!'�` � __. _ .. _ _ _ .. . '� _.. _.., __ _ I PRIMARY CONTACT: ❑OWNER �CONTR,4CTOR ❑OTHER(Please Specify) ; CONTAGT NAME: CONTACT PHONE: �.f- � � - �, j � � � � �') / j �-- r �^ / / i / c, c{ �1 � l �,.�C �? �' CONTACTEMAIL: �C _ 7 , �.afl ...E�-+�U •t�-�aTc „-�G. I �c.� � i BUILDING;PERMtT APPi.ICAT._ION ' _ � Existing Use of Building: Contract Price of Work:$ ! i Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other ( R Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commerciai ❑Industrial i Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑S rinkler ❑Demolition ❑Change of Use • DESCRIPTION OF WORK: ; �C S �� :�C: C � ✓'."r� iG c.: �l �f c� 'r� c� �.t �p `1 ' . •�7 �7 fi � w �. �t'•" ; j'� - j' '�� v � ! L x. 5 T: .�t c/ �'� r T 4;r� �S 'f�;�; ,,,-� �l � �. > j ; �'f C� �--� C��C'•' � T � /d f r r� _ �l - L c2 v > " � aJ C'G� ' ICC � - r"ai�'�� r:.�zfl i�.�,/�C j �- !� �S ti�,.,a 5�•�i r.^ w/h'��t -r. �S C� � �' ljii.: S�-7� � ASSOCIATED BUILDING PERMIT#(if app�icable): - h ��.?�Q ;,,, z - / ' i _ ; MECHANICAL PERMIT APPLICATION - . ; PLUMBING'PERMIT APPLICATION =- ; Type of Project: _New _ Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair #°f List of Fixtures ��f List of Fiztures #of List of Fixtures #°{ List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal = Gas Piping Boiler i: Lavatory(Wash Basin) Drinking Fountain ;; Water Heater Refrigeration Shower Floor Drain s. Gas Fireplace Wood Stove Kifchen Sink&Disposal Grease Trap � Gas Range Ducting Dishwasher Roof Drains � Clothes Dryer Hookups Other: Clofhes Washer Medical Gas Range Hood Water Heater Ofher: j: ExhausE Fan =-�' Sink(ServicelBarlMop/etc.) Other. `:i > SPRINKLER`/SUPPRESSION Sl(STEMs;. Number of Heads ;; ACKNOWLEDGEMENT.'1 have reviewed this application and confirm the rnformafion contained herein is true and correct.Work done pursuanf�o fhis permit musf comply with � current federa/,sfate,andloca/law.The granfing of a permit only authorizes approved work and no deviafions fherefrom.Deviations musf frrst be authorized in writing from the � Buifding O�cial before being authorized under any circumstance.I am the ov✓ner,or 1 am autho�ized by76e owner of this property to perform the work for which application is made, �j and I comply wifh the State Contractors Law 18.27 RCW and 296.200A WAC. ' City of C-veret t O(ficial Use Only G PERMIT�L- .- � //- a3 - / 7 i f �1l ( � ��`� - OwnedAuthorized Agent Signature Qate (Revised 10/1?J2095) �' �� I: i I;