420 48TH PL SE 2018-04-24 - Laserfiche WebLink

PERMIT APPLICATIOI� BUILDIN �.IIECHANICAL/ PLUMBING /SIGN �ZINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits (Blue or Black Ink Oniy Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: °' � a �'G„ �/c>�Lr�J` PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legai description) CONTACT INFORMATION OWNER NAME: ��a�5�!S /C� �u�' TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReer Z O 7� ` C�s S, s - CITY " STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME; � CONTRACTOR ADDRESS: s-rReeT qTY STATE ZIP CONTRACTOR PHONE; CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL• BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ��lr w�'Gt ��ID�/1 VI ASSOCIATED BUILDING PERMIT# if a licable): MECHANICAL PERMIT APPLICATION PWMBING PERMIT APPLICATION Type of Project: _New Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #�f list of Fixtures #of List of Fixfures #�f Lisf of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bidg) 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/SU,PPRESSION SYSTEM Chemical or Water No.of Heads ACKNOWLEDGEMENT.•!have reviewed this applicafion and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply�uith currenf federal,state,and loca/law.The granting of a permif 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.1 am the owner,or 1 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. - Cify of Everett O�cial Use Only � �� `�j PE I � � / ner/Authorized Agent Signature Date (Revised 9/23/2016)