4958 VISTA PL 2018-02-09 - Laserfiche WebLink

477- PERMIT APPLICATIO BUILDIN ECHANICAL/ PLUMBING /SIGN , PRINKLER/ 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 I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2656 .\;fit6, ?lace £vevtit`tsar PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) �1 CONTACT INFORMATION OWNER NAME: i _E p i''\ yfac.K r TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Acle Vis\k - lac- . CITY NiC'',tff_ STATE k)l:\ ZIP g 8.o 3 OWNER PHONE: (215) 551 - r OWNER EMAIL: CONTRACTOR NAME: A po910 .tv‘otr L-LC CONTRACTOR ADDRESS: STREET AI a --0.-_'- Ave N't j CITY ti ln-V3SV \ 1 e..- STATE V ZIP q cA al ! 0 CONTRACTOR PHONE: 431.i J cfl CONTRACTOR EMAIL: l?OQ�r0 p� rt1,Ips r @ ikixk x • ((i CONTRACTOR LICENSE#(REQUIRED): i1po L.L P Lel i 5 LT CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):'D j 5C PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: 4 ( ./ 5 ". CONTACT PHONE: 425 ✓ — 5,_ .006 CONTACT EMAIL: PLAt ky. 6 2_7 5fi �. G.. I ,(pmt BUILDING PERMIT APPLICATION i Existing Use of Building: Contract Price of Work:$ Proposed Use of B (ding: Heat Source: ❑Gas ❑Electric ❑Other Building Type: SFR Detached ❑SFR Attached ❑Duplex ❑Multi-Family#of Units: CI Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel t Repair DTI. ❑Sign ❑Sprinkler 0 Demolition ❑Change of Use DESCRIPTION OF WORK: 4..14..,�lt),�j l CZ.Xe„51 t ,., 5(r$1;QS / (0.S T .I , ci,444 p SSS-(e>M, Cur /- K rf o u ` 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 #of List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures 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 Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: I Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) 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 l 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 r PERMIT# 3121 /► V —P1 (CO 3 -M Owner/Authorized Agent Signature Date (Revised 10/12/2015)