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3003 W CASINO RD BLDG 40-21 2018-09-21
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3003 W CASINO RD BLDG 40-21 2018-09-21
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Last modified
9/21/2018 4:21:54 PM
Creation date
4/27/2018 9:07:57 AM
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Address Document
Street Name
W CASINO RD
Street Number
3003
Tenant Name
BLDG 40-21
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PERMIT APPLICATIOI'- - <br /> BUILDINC; I MECHANICAL/ PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INF RMATION <br /> PROJECT SITE ADDRESS: Scl-c,3 D PROPERTY TAX#: IS" )LIC CrO <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: -,N� TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 70 -2C-7 --0 <br /> CITY eP.- , * `''C I�� STATE ZIP <br /> OWNER PHONE: A� OWNER EMAIL: <br /> CONTRACTOR NAME: J Llc,/� y /� J- L \�G�.^L GCS� I v�-C <br /> CONTRACTOR ADDRESS: STREET L-I. 4*` ATC ` ^ 'nr/�' <br /> CITY �T C`108 �8 ����, STATE V V 1 — ZIP <br /> CONTRACTOR PHONE: Lf?--S- - t-( —2-2(.0(-, CONTRACTOR EMAIL: J C/ © � ✓V _��.. . C <br /> CONTRACTOR LICENSE#(REQUIRED): Sot\NQA M V73 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): ©"ZL( : <br /> PRIMARY CONTACT: ❑ OWNER ;�cONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: yy CONTACT PHONE: (t Z,S L-( S-1 2-Z- L <br /> U� CONTACT EMAIL: ` \ <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ Z C( 3 <br /> Proposed Use of Building: Heat Source: ❑Gas []Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: , <br /> A-L- rsa-=-J 't, #\I'/AC L&API j.-4Ctl <br /> U A VS 9C'L <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Q. 1ncOc� Water Heater Other: <br /> Exhaust Fan V kv s Sink(Service/Bar/Mop/etc.) Other: <br /> 3 L C: a-, S <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT./have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> 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 <br /> Building Official before being authorized under any circumstance./am the owner,or l am authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply the State Contractors La 18.27 RCW and 296.200A WAC. <br /> 2 Cityof <br /> lEverett <br /> y�Official Use Only <br /> Z PERMIT# ; Yb <br /> Owner/Arized Agent S ure Date (Revised 5/20/2016) <br />
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