2916 100TH ST SE 2018-02-12 - Laserfiche WebLink

4re". • PERMIT APPLICATI• BUILDING I MECHANICAL/ PLUMBING /SIGN I SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 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: ......C1/[e 1ce, .57T 5 /z. PROPERTY TAX#: Zzb.S2000/CJ'/OoO LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:3--ITF`� f witi'-7 Cre4g.,xJ/V'2 TENANT NAME(If Commercial): NC OWNER MAILING ADDRESS: STREET 4 /Cs'�j O ;STS . S- ,i ' `J y�� �) CITY )E5-1 V T STATE (-2�vo ZIP Fv Z^� OWNER PHONE: 72 SI/ S�C.i8 OWNER EMAIL: CONTRACTOR NAME: C:)0-)/)ice-- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): • PRIMARY CONTACT: 'OWNER 0 CONTRACTOR 'Z OTHER(Please Specify) f/zS1a-+-1Z- CONTACT NAME: D44.)Fi /W02172(5'4 CONTACT PHONE: -36,c..) - ..5-7-Z. `' 971* 36:,c,__3 7 Z -q z/ CONTACT EMAIL: rt @ULLoiTaS. fE y141tcc: •cc,. AA.. BUILDING PERMIT APPLICATION Existing Use of Building: ,$j//Z. Contract Price of Work:$ '" 7 4- he- Proposed 'LProposed Use of Building: % Itc)--443-C-- Heat Source: ❑Gas ®Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: ❑New DAddition ❑Remodel CI Repair DT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ""' /404917>4.1 1 i....7-CC-k- %LD/J/'Roxo /4///(,,,OW' Coo(4,240 /,(Xtr-=41 rz)(IL' tYz VP'Neel-Oicez 16 x7 is - 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 #of List of Fixtures Fixtures FixfurPs Fixtures Fixtures NC-Air Handling Unitsv7 Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems , Unit Heater Bathtub Urinal Gas Piping 7' Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain ' Gas Fireplac= Wood Stove Kitchen Sink&Disposal ' Grease Trap Gas Ran!- Ducting Dishwasher Roof Drains Cloth Dryer Hookups Other: Clothes Washer= Medical Gas R- ge Hood Water Heater Other: xhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT:t 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# lZ 6 16 1 4 -6Dq r Owner/Authorized A ent Signature Date (Revised 5/20/2016) \, i