7915 UPPER RIDGE RD 2018-02-09 - Laserfiche WebLink

• 0 PERMIT APPLICATION BUILDING I MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION #1111PAI 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 I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1011S t)Ker. 'dise ?.4 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision __Lot_Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: OA t,,t ^ I V L,-, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET lot Is- t` l` c cii, reAu2 STATE 'YA 71;' 2•C OWNER PHONE: 2-0(0 3 `"19 GI 12)G OWNER EMAIL: CONTRACTOR NAME: CV/ 1411 fl(j-- CONTRACTOR ADDRESS: STREET 1L6 yba L0) Ceoezeti- STATE WA LIN °t C) I CONTRACTOR PHONE: S P.59 O$ ) CONTRACTOR EMAIL: fl' r{- i( CkYIVieaifit@ • COM CONTRACTOR LICENSE#(REQUIRED):cry-mtej,myt 11d n CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 1 .FCJo( PRIMARY CONTACT: 0 OWNER 1 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME:p , CONTACT PHONE: t'SCI f V1z d i CONTACT EMAIL:Otered t-{-I"1'v/' C,rYI emir'j •t0 M BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ 3 7O0 Proposed Use of Building: Heat Source, 1Gas DElectric ❑Other Building Type, FR-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: 'R-cp iou_k_ CD--P ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION y ...... Type of Project: New _ Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair #of Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump Toilet 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 Roof brains _Ducting Dishwasher Clothes Dryer Hookups Other: Clothes Washer _ Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Map/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 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. Aci1/41 (.� f n/� City of EJveerett Officiall UUse Only]/ f` ' I, 41/4— ` 1 PERM( f 1 I� V l( J 2-S - CI), Owner/Authorized Agent Signature Date (Ravisad 9/23x2016)