2715 12TH ST 2018-04-17 - Laserfiche WebLink

PERMIT APPL.ICATIOI ( �' BUILOIN 'MECHANICAL/PLUMBING/SIGN rifISRINKLER/ DEMOLITION f `d' _ CITY OF EVERETT PERMIT SERVICES r -,/:.,-I 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits Mule or 1:lack Ink Only Please) P;':OJECT SITE IIN"FORMATIO r- PROJECT SITE ADDRESS: 2/ \ 5 / '2.-r-'' 1 PROPERTY TAX#: 2.90 S-77 00 /O3 2.60 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) N C INTACT liMIFO!'MATION OWNER NAME: EAffeerc l -00_c) p I 1 , TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREEr 7(O 7 C-o( �, N r c- q µ c- c,,,, ��• E 1 1 1/V STATE A- ZIP 9 5 t OWNER PHONE: OWNER EMAIL: • CONTRACTOR NAME: --1--3 N) CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE/#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: iI OWNER ❑CONTRACTOR 0 OTHER(Please Specify) 7 CONTACT NAME: CONTACT PHONE: (-F2:5--- 2Qj 3 " _5`co 1 -2j T-- -1- ®t'L_ '-tict-'Jt-2 `-� 3 CONTACT EMAIL: � k e--.Li 1'N ,� 6 :UILDING PERMIT APPLICATION - oto Existing Use of Building: Al 6,-4-M '}S Contract Price of Work:$ .O 1 DOC• Proposed Use of Building: Sfj-cvlE /Heat Source: ❑Gas ❑Electric DOther Building Type: DSFR-Detached DSFR-Attached ['DuplexQMulti-Family#of Units: q 0 Commercial ['Industrial Type of Project: ❑New ❑Addition DRemodel ❑Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: _ ( , 1�r AL) ,-(,) v , J lo,,,,,, , Com- lJa,y • '" ASSOCIATED BUILDING PERMIT#(if applicable): 6 a.k- MECHANICAL PERMIT APPLICATION PLUM!:ING 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 Ill Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Li Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove - Kitchen Sink&Disposal Grease Trap Gas Range Ducting LI Dishwasher Roof Drains -f Clothes Dryer Hookups Other 4Clothes Washer Medical Gas CI Range Hood Water Heater Other: PS Exhaust Fan I Sink(Service/Bar/Mop/etc.) Other: SPRIIdIKL E' /SUPPRESSION SYSTEM Chemical or Water 9 No.of Heads A ACKNOWLEDGEMENT 1 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.l am the owner,or am authorized by the owner of this properly to perform the work for which application is made, and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only -----Y--' 11111111111116.- 3- ) `--72-- gr: PERMIT# Owner/Authorized Agent Signature Date (Revised 9/23/2016) I�