419 74TH ST SW 2018-04-25 - Laserfiche WebLink

PERMIT APPLICATIC �UILDING /MECHANICAL/ PLUIVl�ING /SIGN /SPFtINKLER/ DEMOLIT'ION 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 Please) PROJECT SITE INFOIZMATION PROJECT SITE ADDRESS: �^��( "� �'I�' S'f-.�SL.I � PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) GONTACT INFARMATION OWNER NAME: �c�So.. ' a � St'C t� TENANT NAME(If Commercial): OWNER MAILWG ADDRESS: srrteer 'y� �j "Y� �- c..1 CIN STATE , �/�� ZIP � �'�� OWNER PHONE: 2p�. - '�! 3� ��f'7 t i OWNER EMAIL: (J � CONTRACTORNAME: �„r' •f SE,tvi..t3 CONTRACTOR ADDRESS: s-rReeT a � (, �- cirr �` ,�' STATE y✓V4 ziP Q� CONTRACTOR PHONE: -Z, _�AS�.� G�il CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): 1c`�/'�C V e ,T J�SP�G CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 2� PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) � � CONTACT NAME: CONTACT PHONE: 'L j- L � ""l�S�� GG t ��"$�4n ��•�°'11^( CONTACT EMAIL: � � BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 5 d i� � "-' '1' Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached SFR-Attached ❑Duplex ❑Multi-Family�#of Units: ❑Commercial ❑Industriai Type of Project: ❑New ❑Addition ❑Remodel �air ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: W G�r SCJv�c.G �\/�,s�-i,�(S-(�0., , ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PWMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New Addn _Aiteration _Repair #of List of Fixtures #of List of Fiztures #of Lisf of Fixtures #of List of Fixtures Fintures Fi�ctures Fixtures Fixtures A/C—Air Handiing Units Heat Pump Toilet Backfiow Preventer(Inside Bldg) Forced Air Systems Unit Heater � Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basinj 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.�l 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/oca/law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be aufhorized 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 1 comply with fhe State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett O�cial Use Only PERMIT#n�n �` / �n ^ - i!/Z z-/ r � l � `l�lJ ned uthorized Agent Signature Date (Revised 9/23/2016)