2719 12TH ST 2018-04-17 - Laserfiche WebLink

� PERMIT p.PPLICATlO� �UILDI� MECHARlICAL/ PLUMBING I SIGN I SPRINKL.ER/ DEMOLIl"ION 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 LnI� Only Please) i�E�OJ��T SIYE IR1FOftM�4T10F! PR�JECT SITE ADDRESS: �� 7 � Z.'� S R' PROPERTY TAX#: ��}Q�I�O� f O;� LOl� LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long Iegal description) COPI'�'ACY IPdFORMAT10iV1 OWNER NAME: ��c-t,..l � [�t,,i�j , �(,_. �'�jJ j� , TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREEr Cj �j �'L C�T�' �J��G r' STATE W� ZIP � C_LJ' OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: T 3� CONTRACTOR ADQRESS: srReEr CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: OWNER ❑ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: �z j— 2�'3 _ � � - '��x� O�,.i�, �?ry-�r� t ��"—'�j� CONTACT EMAIL: ,f--�� , � � t'ti/ � • �_ BUILDING PERMIT APPLICATION Existing Use of Building: }-M�e�% }T Contract Price of Work:$ �� :.:'L'C`• - Proposed Use of Building: Sfj--ry�� Heat Source: ❑Gas ❑Electric ❑Other Buiiding 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: ( �- . --_ L 1� f � C_�i.:+M1-� _ Z.,� � � l� nu�J ASSOCIATED BUILDING PERMIT#(if applicable): '�'��'�f,,� 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 List of Fixtures #of List of Fixfures #of List of Fixtures Fixtures Fi�ctures Fixtures Fixiures A/C—Air Handling Units Heat Pump Toilef Backflow 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 Clofhes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhausf Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSIOId SYSTEM Chemical or Water No. of Heads ACKNOWLEDGEMENT.�I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply wit1� currenf federal,state,and local law. The granting of a permif only aufhonzes approved work and no deviations theref�om.Deviatrons must first be authorized in w�iting from the euilding O�cial before being authorized under any circumstance.1 am the owner,or l am aufhorized by the owner of this property fo perform the work for whicl�application is made, and l comply with the Sfate Contractors Law 18.27 RCW and 296.200A WAC. City of Everett O�cial Use Only ` �- PERMIT# , � ' - S ^ �� ' � �-( `76�, '� l ; Owner/Authorized Agent Signature Dafe (Revised 9/23/2016) '� �� ; 1�-- !