709 91ST PL SE 2018-04-05 - Laserfiche WebLink

47-T PERMIT APPLICATION BUILDING/MECHANICAL/PLUMBING/SIGN I SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 E FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwai.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 674 1 I S,f Put PROPERTY TAX#: O j) ,G PS--700 Op I if(7C LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) 1 CONTACT INFORMATION OWNER NAME: )elf-.Z UJ (0 tAJ S TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 7®7 q. I Si- 1 S E /may CITY f ere 1{ t- STATE (A/,Pr ZIP Te2 (,s OWNER PHONE: 7c7 g 6/y -Q332 OWNER EMAIL: e("Zy 1g 7g e.g lt- q f f GG CONTRACTOR NAME: < /L CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: pWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 330(...) Proposed Use of Building: Heat Source: ,®Gas ❑Electric ❑Other Building Type: CISFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ZChange of Use DESCRIPTION OF WORK: cr10CI06 E)c t5-/in.j . /ecirIC. ‘,vaiffr, €4" 4-'0 64S 14 fc�'r c(vtc/ /Pch"tcr J2"cr 6a 1r h tc,-- ,fro }V /rC ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New_ Addn Alteration J4Repair Type of Project: New Addn _Alteration _Repair #ofList 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 I 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 1 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/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 ' J , /611,444% P T Wte.. 6 • r/Autho • gent Signature Date (Revised 9/23/2016)