8301 XAVIER WAY 2018-02-26 - Laserfiche WebLink

PERMIT APPLICATION r0..//--a BUILDING / MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION ,./ CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJE.C/T SITE INFORMATION PROJECT SITE ADDRESS: (6720 I XA�L( �i JZW l PROPERTY TAX#: LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 'CA-12.• * TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET cL'G VAV( T - \/i) /67--(73 CIN QVe 12.- -"Tr STATE WA ZIP OWNER PHONE: �L�j - W:j1 • till 1 OWNER EMAIL: CONTRACTOR NAME: RR--P HAt&HI-4 S 'zest Gvakrf A t/ : UNIT CONTRACTOR ADDRESS: STREET 15 ° ' M E ' '1 4t A i 0 /,,�J iJQJZ ii. -1 CITY Iz pitA 7 STATE WA ZIP_``.61% CONTRACTOR PHONE: 1-1-7-G - gg( • ci-7 fl CONTRACTOR EMAIL: ktet`o(1® I atrv(,)(4atgt.t-01141 CONTRACTOR LICENSE#(REQUIRED): (.ACZr'f%1 Z4t 17 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):D 22 1,)() t) PRIMARY CONTACT: ❑OWNER ,CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: L.1.7.9 - g$( • errif AAtt Aet, ifAlt`T T CONTACT EMAIL: VW c(&ctet 0 (ay r kat'g( tt -L6yyi _ BUILDING PERMIT APPLICATION Existing Use of Building: tit)M, Contract Price of Work:$ II ) 000• 00 Proposed Use of Building: Heat Source: DGas ❑Electric DOther Building Type: SFR-Detached ❑S�tFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑ ❑ Commercial Industrial Type of Project: DNew DAddition Remodel DRepair {2-01,F ❑T.I. ❑Sign DSprinkler ❑Demolition OChange of Use DESCRIPTION OF WORK: MCV �XtSTi 106, 2 c 2tN&M> lz.c-AL) 1NISTPcLt. NeW t/.-`f pts 00O/ U1,117 -1 A'fMWT ek14D 12ao�tN&c,4-h11& S 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 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 WaterHeads 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. City of Everett Official Use Only PERMIT# `74_____, Owner/Authorized Agent Signet re Date (Revised 9/23/2016)