4427 RIDGEMONT DR 2018-02-23 - Laserfiche WebLink

417-r PERMIT APPLICATION BUILDING I MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SER\/ICES 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: 9427 K 401-1-Dr PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: tor( Web 4, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET ''''`gyp CITY STATE ZIP OWNER PHONE: 1125Z5 3Zq7 {( og OWNER EMAIL: CONTRACTOR NAME: l" Y l liC4-11116- CON TRACTOR ADDRESS: STREET 'Lh KbQ d Loot ciiv (;/�/��y� � STATE W//Ay, za IDIS20 I CONTRACTOR PHONE:4135 59 05 CONTRACTOR EMAIL: d tot '-( C.(ty icl-ea ivt-5 • coyv CONTRACTOR LICENSE#(REQUIRED): Cmt1 rvtjv4 lid rl CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 160C'(1:8 PRIMARY CONTACT: 0 OWNER IO CONTRACTOR 0 OTHER(Please Specify) CONTACT Ne^/I CONTACT PHONE: a5 ;s9 cl:�d . _ DI` C- CONTACT EMAIL: n G GPh e0. i q •to rn BUILDING PERMIT APPLICATION 1 r �j Existing Use of Building: Contract Price of Work: $ 324 7•�j_1 Proposed Use of Building: Heat Source: '3as ❑Electric ❑Other Building Type KFR-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: 1.e,p lacy 9 ck,. r via _ 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 Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures _NC–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: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Chemical or Water 1 !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. �j / City of Everett Official Use Only 414 �,��. 4.�. c/ •6 •I PERMITI(- -c15 - 07\5 Owner/Authorized Agent Signature Date (Revised 9/23/2016) De mi e ►3cu t2-