1307 50TH ST SE 2018-04-24 - Laserfiche WebLink

PERMIT, APPLICATIO� BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOL.ITION 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 Only Piease) PROJECT SITE IMFOItMAT10W PROJECT SITE ADDRESS: l O� Jv�'� ST �C PROPERTY TAX#: LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: (,ri TENANT NAME(If Commercial): OWNER MAILING ADDRESS: s-rReer CITY 1 STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME; GL7�GJG12 K�S /vbL>`T��ES'� CONTRACTOR ADDRESS: sTReer I Zq�� G 7� � �� CITY �� (/L� STATE "l��`T ZIP S� CONTRACTOR PHONE: �o•��lb'. EI�'3I CONTRACTOR EMAIL: ��9� �F�ueiCk'f/�„�r,qr _ _�e�� CONTRACTOR LICENSE#(REQUIRED): �ZDDICtJlV��U�o CITY OF EVERETT BUSINESS LICENSE#(REQUIRE ): PRIMARY CONTACT:_ ❑OWNER ONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ZOC� ��f�. zf`�,3 � �� CONTACTEMAIL: ,,,� �p��F��p{�7w� _Cc�-� BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ f� �`� Proposed Use of Buiiding: Heat Source: ❑Gas Electric Other Building Type: FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family�#of Units ❑C mercial ❑Industrial Type of Project: ❑New �Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑ moli' ❑Change of Use DESCRIPTION OF WORK: f�� ASSOCIATED BUILDING PERMIT# if a plicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICiAT10N Type of Project: _New_ Addn _Alteration _Repair Type of Project: _New Addn _Alteration _Repair #of Lisf of Fixtures #�f List of Fi�ctures #°{ List of Fixtures #°f List of Fixtures Fixtures Fi�ctures 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: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water No.of Heads ACKNOWLEDGEMENT.�I have reviewed this application and confirm the information confained herein is true and correct.Work done pursuant to this permit must comply with current federal,sfate,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 properly to pe�form the work for which application is made, and I comply with the State Contractors Law 98.27 RCW and 296.200A WAC. Cify of Everett O�cial Use Only PERMI� �� (� S Z�� ` '�' � O ner�Authorized Agent ' ure ate (Revised 9/23/2096)