4612 SEAHURST AVE 2018-02-09 - Laserfiche WebLink

Oren" • PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 4/4 /2 S aA rc.-w A�„a , PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision P/cL'7 m Lt p%e 14 0 4It:1I No. /© (attach copy of long legal description) tk 4 /'0 Pa,4)<2,3 cv 4 CONTACT INFORMATION OWNER NAME: D e)A/Q I el 4 ZQv�/Q (i. ,, v't,e i'-- TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET I/6 12_ 5'/ i .. vd -�}-/- jA i,1 ., �1J ._.i CITY '`v✓ E L� Ell-- STATE W C'�..y IL, ZIP ZIP q U 2 o 3 OWNER PHONE: 1/23 - 2.S2 .- 6,U(, 7 OWNER EMAIL: CONTRACTOR NAME: 0 /sA irk,y-- r A ,e Ai 0, i 54, ..1,--A L CONTRACTOR ADDRESS: STREET r/F 0 i -t�esx /D C,/ 1 4 �/ cITY Aku.>I�l / 1 C-a. STATE r1.A.]�4 ZIP / O 27J CONTRACTOR PHONE: ' 2.5 — Z -3 q_V Sf%U CONTRACTOR EMAIL: — ----- ==--'. cl CONTRACTOR LICENSE#(REQUIRED): O.' to j{ A Q- 0 72A4 9 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): D/a3 L.,I 1 PRIMARY CONTACT: ❑ OWNER `CONTRACTOR 0 OTHER(Please Specify) - - CONTACT NAME: 0?i/l&t'— �A/-5CONTACT PHONE: z- 23 Cj 6 57, .9.A1\ 1 1 cirikii CONTACT EMAIL: _._- ---. BUILDING PERMIT APPLICATION Existing Use of Building: 1-- /.- . 5 r4 Contract Price of Work:$ 21,5-6.U Proposed Use of Building: 1_c 1)E1r ell)f`:v-' 54-j v-'S Heat Source: ❑Gas Electric ❑Oth r Building Type: feSFR-Detached ❑SFR-Attached ❑Duplex OMulti-Family-#of Units: ❑Comm cial ❑Industrial Type of Project: ❑New I Addition ❑Remodel ❑Repair DTI. OSign ❑Sprinkler Demolition lJChange of Use DESCRIPTION OF WORK: 4 �d q — X 2 7 �'a ° 0 v`- 6 `F" ..5'--1-6c, k,-s j--2,6 tx.6 e., i Af` — i 2_u -5 ° 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 C#of List of Fixtures #of List of Fixxtures Q#of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixture A/C—Air Handling Units Heat Pump Toilet / Backflow Preventer(Inside Bldg) Forced Air Systems tnt Heater Bathtub / Urinal Gas Piping 'Boiler Lavatory(Wash Basin)? Drinking Fountain Water Heater Refrigeration Shower / Floor Drain Gas Fireplace i Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range /' Ducting Dishwasher ' Roof Drains Clothes Dryer Hooku Other: Clothes asher Medical Gas Range Hood Wate eater Other: Exhaust Fan Si (Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water I 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 with 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 Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official/Use Only PERF k s V n_7_(.0`.0 tde,... __...- Owner/Authorize./•dent Signature Date (Revised 9/23/2016) y