5039 OCEAN AVE 2018-04-13 - Laserfiche WebLink

PERMIT APPLICATION 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 ((E)everetteps@everettwa.gov I www.everettwa.gov/permits , ..,, PROJECT SITE INFORMATtO , ... >.` . , .„"M .,. ..4.. , . PROJECT SITE ADDRESS: �34 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ONTACT NFO000it ''', . OWNER NAME: is 0 LL,C T TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 36o S SI S r PI. S ) CITY SvaZerr STATE WLt zip it zo 3 OWNER PHONE: 3(eO (pi 52$2 OWNER EMAIL: E wktd, c.6.1 Ce•c.•C,a)„•. CONTRACTOR NAME: pW rJ CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING ERI�IIT AIPLIC,A9�TION. Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair DTA. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: lMo` -r,4 Pte,t; 1-6Q s.E- Rae ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION ,': PL.UMBING PERMIT APPL•ICA ION Type of Project: _New Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #of List of 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: SPRINKL ER I SUPPRESSIION SYSTEI'(ll 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•efor_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 ith he 'tate Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only / Af PERMIT#' o i if f( � 1) 1 (063- ci Owner/Au .11/1":d Agent Signature Date (Revised 10/12/2015)