2301 COLBY AVE 2018-03-12 - Laserfiche WebLink

PERMIT APPLICATION ,,� BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION 4011111 CITY OF EVERETT PERMIT SERVICES J 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) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2 30/ C_Oa q k/f err4' 0 G PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision ✓ Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: k_C7"/�L/V eet4 Al Q( Gh(7!/ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Z0/ ("( 6i.. Q '-t/ �`"6 CITY , / .,1 /r I 1�STATE �.. / ZIP O/ -7-Go,OWNER PHONE: -7-Go, 7�-/,�/�^ OWNER EMAIL: 67--()I"(r" yalce'4Ok CONTRACTOR NAME: Q CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: sic.ld..�.USr-ls cm Contract Price of Work:$ (1 bh6 Proposed Use of Building: Heat Source: El Gas DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex Multi-Family-#of Units: DCommercial 0 Industrial Type of Project: ❑New DAddition DRemodel DRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: � X62 ) __ _/J� r}�,,� LeAtd.Z- ¢ 11- 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 #°f List of Fixtures #of 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,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# 01 - 003 Owner/Authorized Agent Signature Date (Revised 9/23/2016)