840 N BROADWAY B 2020-08-26 - Laserfiche WebLink

PERMIT APPLICATION BUILDING 1 MECHANICAL/ PLUMBING 1 SIGN 1 SPRINKLER I DEMOLITION CiTY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 4(E)everetteps@everettwa.gov I www.everettwa.gov/permits - a (Blue for Blackank'Only'Please) PROJECT SITE INFORMATION PROJECT SiTE ADDRESS: �{ �j t2 d,a t'J f} p PROPERTY TAX#: LEGAL for new construction: Shoo Plat/subdivision Lot No. _ (attach copy of long iegal description) `CONTACT INFORMATION OWNER NAME: M G RDu 6 0T pQo �t e TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET X l,!5 5T crrY STATE CA zip 9-5&1 66 OWNER PHONE: qj(p - S - S�/ OWNER EMAIL: Irlwr/.5ol1iQ f-r rou • Cor-\. E t CONTRACTOR NAME; i CONTRACTOR ADDRESS: SIHEET / i'�d p/ jZ• p CITY ge,rJ ��jL^ STATE la1 ZIP t�� r� 3 CONTRACTOR PHONE: `i00- Zf30 • 6-OZ-6, CONTRACTOR EMAIL: 41-;6,1/TCS YI�T�fut�l�n v SNG-Coir CONTRACTOR LICENSE#(REQUIRED): PLATTP—I 8 4q nI o ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER [A CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4/0 6-72,6- 6 Z 4Liz 1j CONTACT EMAIL: pt +Gltr@ �ATt�tuw-�no ►- �'ntc COr�, BUILDING'°PERMIT AIP1IOATION Existing Use of Building: 61Mm e-4e , lContract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas ❑ ectric ❑Oth Building Type: ❑SFR-Detached E]SFR-Attached ❑Duplex ❑Multi-Family-#of Units: MCommercial ❑Industrial Type of Project: ❑New ❑Addition Remodel ❑Repair ❑T.L ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ReR0op- wl5S,j1e PLy ?VC rAe�b>2a� a�alt titsT,�� aPM S'r�rq/eP/� ` w ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION Ir Type of PLUMBING'wPERMIT APPLICATION Type of Project: _New _ Addn J _Addn _Alteration _Repair #of #of #of #of 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) j 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 Plumber of Heads ACKNOWLEDGEMENT.'I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit roust 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 PE T# O nerlAuthorized Agent Signature Date (Revised 512012016)