2707 12TH ST 2018-05-02 - Laserfiche WebLink

PERMIT APPLICA7'10t�1 BUILDIN��IECHp►NICAL/PLUMBING/SIGN I'�■�INKLER/ 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.everetiwa.gov/permits (Blue or Black!nk On1y Please) P�tOJECT SIYE IIdFORMATIOM PROJECT SITE ADDRESS: Z�C�� J Z�' � PROPERTY TAX#: �9L?S��D� jQ� 2(?Z� LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT IiVFORMAT10P1 OWNER NAME: ��G'�� (�j,,�� (� �"�i"�'}.� , TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srReer � �j �'L �� G � STATE W iI� ZIP g G_.a„/� OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME; T�� CONTRACTOR ADDRESS: srRee-r cin' 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: �z j— 2�"3 .. � � T�-K� ��, ��-s� � �—�� CONTACT EMAIL• d— � � � .�.� � , � BUILDING PERMIT APPLICATION Exisfing Use of Building: }-r�� '}T Contract Price of Work:$ 1 7��d 1� Proposed Use of Building: Sfj-rv�� 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: � . l�,�;�� .f-�� f .. � �� '��v„� - .._Y"'-" T� Z ASSOCIATED BUILDING PERMIT#(if a plicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn _Alteration Repair Type of Project: _New _,Addn _Aiteration _Repair #of List of Fixtures #of List of Fixtures �°f List of Fixtures #°f List of Fixfures Fixfures Fixfures Fixtures Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unif Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Wafer Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposai Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Ofher: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water No.of Heads ACKNOWLEDGEMENT.•1 have reviewed this applicafion and confirm the information contained herein is true and correct Work done pursuant to fhis pemtit must comply with current federal,state,and local law.The granting of a permit only aufhorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from fhe Building O�cial before being authorized under any circumstance.1 am the owner,or I am aufhorized by the owner of this property to perform the work for which applicafion is made, and I comply with the Stafe Confractors Law 18.27 RCW and 296.200A WAC. Cify of Evereft O�cial Use Only � ------�_. �- PERMI # �O _ � � � �— � � Owner/Authorized Agent Signature Date (Revised 9/23/2016) `,�