4612 SEAHURST AVE 2018-02-09 - Laserfiche WebLink

OLT • PERMIT APPLICATIO• 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 `//t PROJECT SITE ADDRESS:` 12 5E j1,(.L\;s4- 4 LJ PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision 1A4,p 1I' /./f •H Lot No. 7d (attach copy of long legal descrip / /D �' I 23 g � CONTACT INFORMATION OWNER NAME: Do A/ 4- )')l (ry„--1& C..„.(IL.,,..)'t-(,_=1,-- TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 4 4 /2 S/-c,((,t✓V•-r'4" ,t1 " 11 CIN V c V—E STATE /.c,/ ZIP g 6, 2 U$ OWNER PHONE: i 2S=- „s7,, ,� CaO 4,7 OWNER EMAIL: __.-- ---_.- CONTRACTOR NAME: 0 jaL..,e E./.6'E,A/ C 4N 51-, 701 I CONTRACTOR ADDRESS: STREET pc'`.a /b L/ CITY u,.._ k : (7EL V STATE ZIP 9 CONTRACTOR PHONE:V2 -• 2 3 4�« 04570 CONTRACTOR EMAIL: ----- f+�J ^J -A CONTRACTOR LICENSE#REQUIRED© CITY OF EVERETT BUSINESS LICENSE# Q(IRED: nz_ 3 U PRIMARY CONTACT: 0 OWNER [ CONTRACTOR 0 OTHER(Please Specify) CONTACT N/A�ME: CONTACT PHONE: �` ---- _--� 0A'< tL t- N6•5 JCC/ CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ #20, X06 Proposed Use of Building: �Yk,y`de._4 F- Heat Source: ❑Gas ❑Electric ❑Other NGN/= Building Type: OfSFR-Detached ❑ R-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: gNew DAddition ❑Remodel ERepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: A” 1 D E (0-e-.1,Ed ,`a.‘,- C / p E x is C.e.t, r o(,-f. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: g'New _ Addn _Alteration _Repair Type of Project: X New _Addn _Alteration _Repair 0#of List of Fixtures #of List of Fixtures �#of List of Fixtures n#of List of Fixtures Fixtures ixtures Fixtures "fixtures NC—Air Handling Units / Heat Pump Toilet Backflow,Preventer(Inside Bldg) Forced Air Syste s / Unit Heater Bathtub Urinal,/ Gas Piping j/ Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater %/ Refrigeration Shower Floor Drain _ Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap 1 Gas Range / Ducting Dishwasher ;\ Roof Drains Clothes Dryer Hookupts "\ Other: Clothes Washer Medical Gas Range Hood Water Heater bier: Exhaust Fan Sink(Service/Bar/Mop/e) ) Other: SPRINKLER/SUPPRESSION SYSTEM Number 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 PERMIT# 10P.. '.1 , !.. i 0 -,$ )1lU Owner/Au .••-ze. •bent 'ignature Date (Revised 5/20/2016) 1 k...„..._