120 93RD ST SE 2018-04-25 - Laserfiche WebLink

I' II' ��ir�P��.ic,��ioN � �UILDING7 MECHANICl�►L/ PL.UMBING /SIGN /SPRINKLER/ DEIVIOLITION 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 Inlc An1y Please) PROJECT SI'i'E IMFORMATION PROJECT SITE ADDRESS: Q3,-b � � PROPERTY TAX#: LEGAL for new construction: Short Platlsubdivision Lot No. (attach copy of long legal description) CONT�iCT INFORMATION OWNER NAME: :� �G lQ C� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: s-rRee-r (� �"'°°�� S CITY " STATE ZIP �j -O OWNER PHONE: � - 3 -- OWNER EMAIL: CONTRACTOR NAME: �'U �� ,�., �fQ� � � CONTRACTOR ADDRESS: s-rReer I -� c�rv I STATE ,� zia (��- CONTRACTOR PHONE: �j' S- CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): j „�y,3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): �I,�J�J PRIMARY CONTACT: ❑OWNER I�CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: � _ 7Sc�-� � �`c T1' 1` �kG-� CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: �, t Contract Price of Wor :$ Proposed Use of Building: Heat Source: ❑Gas Electr' er 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: �t��r-� j�t/oi�/ �!�'a'�,P� c'LQ-�c�l-r�.�./ ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PWMBING PERMITAPPLICATION Type of Project: _New _ Addn Alteration Repair Type of Project: _New _Addn Alteration Repair #of List of Fi�ctures #of List of Fixtures #°f List of Fixfures #°{ List of Fixtures Fixfures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow venter(Inside Bldg) Forced Air Systems Unit Heater Bathtub Uri Gas Piping Boiler Lavatory(Wash Basin) rinking 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 Wash Medical Gas Range Hood Water He r Other: Exhaust Fan Sink ervice/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION`SYSTEM Chemical or Water No.of Heads ACKNOWLEDGEMENT.�l have reviewed this application and confirm fhe information contained herein is true and correct.Work done pursuant to this permif 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.1 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 Otficial Use Only � � ' P��.�02 � �� S O r zed Agent �gnat e D (Revised 9/23/2016)