840 N BROADWAY 2018-02-23 - Laserfiche WebLink

(4rEn- PERMIT APPLICATION BUILDING I MECHANICAL I 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: O e/rrc-_ VJA q(S2(5l PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) 1 CONTACT INFORMATION OWNER NAME: t1—t MZ. Qc L-setc4r CVv1 Le< TENANT NAME(If Commercial):1/400. „c Seel rOca\-0,•CvAs OWNER MAILING ADDRESS: STREET 1I.�,aPlr_tc ?�� o,, S�w lc 340 CITY N c, `jova STATE /lkW. ZIP OZ 41.j g OWNER PHONE: iA3 L -r al t r\ztoncov.2c Z/Io W `OWNER EMAIL: M4kowe pccv.LJ r-,mAr�rr,,�, ,God CONTRACTOR NAME: Nr.li, IJP CONTRACTOR ADDRESS: STREET 2.5111 4-I 1 144 nu CITY Y�(�y�'C STATE J'F"' ZIP ! J O V CONTRACTOR PHONE: '253, °r 7 47? CONTRACTOR EMAIL: 2) e y1/4 ct-Alo,K. iCovvk CONTRACTOR LICENSE#(REQUIRED): f`I I•T 1(>fur, CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (j c og 6 PRIMARY CONTACT: ❑ OWNER $CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: cn G( r 73'7 - 7 0/ Jcr�r..y LCC CONTACT EMAIL: j'e 1‘(1,4-1‘ch,, r.cevnCtCrAM BUILDING PERMIT APPLICATION Existing Use of Building: vcrwy•-cam i' r s Contract Price of Work: $ );06 Proposed Use of Building: Gr.,�crs .3c;v i(LA Heat Source: ❑Gas ❑Electric .Other N I ¢' Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ,ICommercial El Industrial Type of Project: ❑New ❑Addition ❑Remodel ,Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: q /+ / ee CJ�e � Clf iS'I`t TPC) rc c- t j t. `/&" �C..S fJ fr.�C r�^^Y L1^c�C r](60 ., t G�.y TPo. w,,fly wc.ti& 4« SCa..v,..s o.v.c 'dPlc,S1A. V1cc-VS r7. QI( V„o-k. Fo ".."..\v, v. 144-, , ASSOCIATED BUILDING PERMIT#(if applicable): IMMO MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn _Alteration _Repair Type of Project: New Addn Alteration Repair #of List of Fixtures #°f List of Fixtures - #°f 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: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/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,a 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 'ng uthorized 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 to tractors Law 18.27 RCW and 296.200A WAC. City of Everette Official Use Only IS �17 PERMIT# n ( -7 09 _Ci- Owner/Author) ed Age t nature Date (Revised 9/23/2016)