2625 HOYT AVE 2019-01-11 - Laserfiche WebLink

• PERNIIT's4PPLIGAI'IO� �IJILDIiVG/iif1ECFlA�IIC�,L I PLl1VV1E�l�lG /�IG�! I�9�RIRlKL�R I DE�JIOLIYIOi� CITY OF EVERGTT PERMIT SERVICES 3200 C�DAR STREET,EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits (�lue or�lack Ink Only.�lease) �R�.1��7'SI`P� IRf�'��Ml�'PIOR[ PROJECT SITE ADDRESS: �.�:"l7 �'�� PROPERTY TAX#: Fj�>L3�i Z�i ��%` �� LEGAL for new construction: ShorE Piat/subdivision Lot No. (attach copy of long legal description) _ CANTACIf' INFORM�,'�ION OWNER NAME: �t1L `��%�Fj/ �r*�-��C� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTR�Er ',�-L� �C+ t �f.� CITY �� ff-F � �C� � STATE ZIP OWNER PHONE: OWNER EMAIL: j_�L�2.1.� �Ll,�c�j L� F�-pL _ ' �h� ___ _._..._._.. .__.__.... ...__. . . _..,...-_,_.... .. . .._. _____......_.- ___ .... ..._ . .. ..... ........... ..__....._._. ._ . . ..._,._ .. _., ... .._ CONTRACTOR NAME: C v�rLC�(�-[�� STta-Tc� �7f'�EET(M,6'�'-i4-C. CONTRACTOR ADDRESS: sTaEET 'LI'ZO AL�� 14�(�� CITY V:G V GYL�T STATE �(/�- ZIP �� CONTRACTOR PHONE: �2S-'Z S 2'�jI I CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): ��{�`�(�.SS 02Z0 CIN OF EVERETT BUSINESS LfCENSE#(REQUIRED): (]b �j" PRIMARY CONTACT: ❑OWNER I�.CONTRACTOR ❑OTHER(Piease Specify) CONTACT NAM�: CONTACT PHONE: l.f 2 g_�SZ_��C� �/�1�=- , y CONTACT EMAIL: JJ/)�G�C,r� `�5cj�,Zu,!q -C`d yi•l BUILDING PERINIT APPLICATION Existing Use of Building: L-�j,U✓'��' � Contract Price of Wor4c$ �°�Jl�'� �' Proposed Use of Building: ��,U v`�� l�,r,� f.lv�1��' Heat Source: �Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New DAddition ❑Remodel lz�Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: y/-{'�� . ��Z �� ✓/�'�� LL�I I"� LC�C� `r'C� �L�.�f. 7 !`�'j� �d"V� (�'}//J G ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLIaM�IMG PERMIT APPLICATION Type of Project: _New _ Addn _Alterafion �Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Frxtures #�f List of Fixtures �°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Unifs Heat Pump Toilet Backflovd Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration 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 Wafer Heafer Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: ��RiIV��/��JPPR��YOP�➢ ��F�Yl�Ni Number of Heads ACKNOWLEDGEMF_NT.�l have reviewed this application and confirm fhe information contained herein is true and correct.WorR done pursuant to this pem�it must comply with cur�ent federal,sfate,and iocal law. The granting of a permif only aufhorizes approved work and no deviations therefrom.Deviations must first he authorized in writing from the Building Offcial before being authorized under any circumsfance.l am the owner,or I am authorized by fhe owner of this property to perform the work for which application is made, and l comply with the Sfafe Contractors Law 98.27 RCW and 296.200A WAC. City of Everett Officiai Use Only „� PERMIT# �`�---- l- `Z5-f� , � � -..��, ,. � , � Bae1�f�HAuthorized A Signature Date (Revised 5/20/2016) 4� � ;