11724 23RD DR SE 2018-04-16 - Laserfiche WebLink

PERMIT APPLICATION Ali BUILDINE-CHANICAL/PLUMBING/SIGN/slorNKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES ' ' l 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 j FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.evereftwa.gov/permits (Blue or Black Intl n ase) PROJECT SiTEINFORMATIO PROJECT SITE ADDRESS: 111 20i" 23 ' PROPERTY TAX#: )Yt 001.42 $00LEGAL for new construction: Short Plat/subdivision 11.02• o3/•TM, Lot No._1_ (attach copy of long legal description) . ... ., . CONTACT INFORMATIOR.= r . OWNER NAME: 1.4114144EX. 144 ft Jraytter,)#0 ENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET ,,J�'[VI '2 39 1 2 j cm, 4 .v f tJi STATE kgle ZIP 93 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: £ j.1 CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: "OWNER 0 CONTRACTOR 0 OTHER(Please Specify) ._. CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: )1k�IN "E#thlf lPPLiCk'# �, /�r ' ►.1 Existing Use of Building: �,P,��' ;N'j10 �7 Contract Price of Work:$ (. � 1 Y© W6 �(.� Proposed Use of Building: Y's1,V ri I 1. j Heat Source: ❑Gas ❑Electric ❑Other Building Type: FR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair DTA. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ��1_•"`r SIJ 144"-l)V.T. f—> Mav� ASSOCIATED BUILDING PERMIT#(if applicable): M CH_ANI AL PI RM "T AI?RLICAr ON • PLCJMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project _New Addn _Alteration Repair Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of 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: P) INKLER,I S PPRESSION SY-S_TEM" 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.lam the owner.or I am authorized by the owner of this property to perform the work for which application is made. and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use On/v Az7"-jf , PERMIT4D Owner/Authorizre Date (Revised 9/23/2016) 2N1\) er�