2412 81ST PL SE 2018-01-11 - Laserfiche WebLink

PERMIT APPLICATIQ'° �UILDI�/ MECHANICAL/ PLUMBING /SIG�PRINKLER/ DEMOL1710N 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: ( `j� � a- PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: � � TENANT NAME(If Commercial): OWNER MAILING ADD ESS: STREET � S L�'r Y'�' CITY " STATE ZIP � ��C/ OWNER PHONE: .�C�- j` OWNER EMAIL: CONTRACTOR NAME; e � C C� n •]� CONTRACTOR ADDRESS: srReer G T /� /G CITY STATE ZIP CONTRACTOR PHONE: -'- � CONTRACTOR EMAIL: � - �1/qy� - ' „ 4� CONTRACTOR LICENSE#(REQUIRED): I� C �L� CITY OF EVERETT BUSINESS LICENSE#(REQUIR ): PRIMARY CONTACT: �70WNER L�CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION —��--�� Existing Use of Building: Contract Price of Wo :$ Proposed Use of Building: 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: ��,�� ;�,�„� �� ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #�f Lisf of Fixtures #of List of Fi�cture�� #°f List of Fixtures Fixfures Fixtures Fi�ctures Fixtures ; A/C-Air Handling Units Heat Pump Toilet �-�' Backflow Preventer(Inside Bldg) Forced Air System nit Heater Bathtub �; Urinal Gas Piping Boiler Lavatory(Wash Basin�'` Drinking Fountain Water Heater `., ,i i Refrigeration Shower _ �, Floor Drain Gas Fireplace Wood Stove Kitchen Sink 8r'�sposal Grease Trap Gas Range ,✓' Ducting Dishwasher Roof Drains Clothes Dryer H ups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water No. of Heads ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and correcf. Work done pursuant to this permit must comply with current federal,state,and local/aw. The granting of a permit only authorizes approved work and no deviations the�efrom.Deviations must first be authorized in writing from the Building Otficial before being authorized under any circumstance. I am the owner,or l am authorized by the owner of this property fo perform the work for which application is made, and I coryrp(y with the State Contractors Law 18.27 RCW and 296.200A WAC. � � City of Everett Official Use Only I � PERMIT��^ ^ r �� -�-� L Owner/Au orized Agent ignature Date (Revised 9/23/2016) ' \ I�� 1!/