804 47TH ST SE 2018-04-13 - Laserfiche WebLink

PERMIT APPLICATI #11111,—, _A BUILDIt— MECHANICAL!PLUMBING!SIG PRINKLER!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 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: `aa tf q-rfk S+ S 5. I .0 re-i-a WA 18a03 PROPERTY TAX#: Q O 53(OO 3 0).700 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Rob szi •T' 11 e+1" TENANT NAME(If Commercial): P)A OWNER MAILING ADDRESS: STREET S O"{ 1414(` S�- .55. ` , cm, EV a re,-ff- STATE W P ZIP q ao3 OWNER PHONE: –53b, OWNER EMAIL: CONTRACTOR NAME: g (def I(tipre VC 1 Qt + C�t'oK P CONTRACTOR ADDRESS: STREET PO Lex (3fo t 9 CITY M.t( t:J€d< STATE trUA ZIP g CONTRACTOR PHONE: .V t7 �{0.1_91 6( CONTRACTOR EMAIL: (Z 4I Q t3u.literr �V / cn �&roc.,tp,!_c*. CONTRACTOR LICENSE#(REQUIRED): 3L% L,DtG VC 1 Tr CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 0. 6 PRIMARY CONTACT: 0 OWNER ',CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: Mal-c 0 t AS CONTACT PHONE: a 0 6 go q o y� CONTACT EMAIL: Ma-e@ IIu.`•1 ikc .Mpro verb ott BUILDING PERMIT APPLICATION Existing Use of Building: Dwelt:41 Contract Price of Work:$ i, 000. el0 Proposed Use of Building: tiwct(: Heat Source: ` Gas ❑Electric ❑Other Building Type: ` SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project ❑New DAddition ❑Remodel %Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: o1s(,:G1 e gama7.z repQ�i' 40 *co A4 04 kor.e. ;10,01/ Ri is f Drivo .(t ea.l 1'a44. 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 NC-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 (Number 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 +.A I PERMIT#mA 6_1I3t -3C(01 -� 0Z5 Owner/Authorized Agent Signature a (Revised 9/23/2016)