2711 12TH ST 2018-05-02 - Laserfiche WebLink

PERM17 APPLICAl'ION ,I'. BUILDINC�I�IECHANICAL/PLUMBING/SIGN /�YRIfVFfLER/ 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.everettwa.gov/permits (Blue or Black Lnl�On1y Please) PROJECT SIY� IPIFORMATION PROJECT SITE ADDRESS: `Z.� j ( ( � � � � PROPERTY TAX#: ��L?SyI�D�f O� �Ol� LEGAL for new construc6on: Short PlaUsubdivision Lot No. (attach copy of long legal description) COPITACY INFORMATIOPll OWNER NAME: ��12L�) ��s� (� �"�j+ , TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srReEr Cj �j �'� C� ��`�l. � STATE WJ+� ZIP .� Gy i OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: T�� CONTRACTOR ADDRESS: srReer ciTM STATE zia 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 .. � � 'r�'� Ol��, �� —�� CONTACT EMAIL: ,�-- � � � �a.� � � �, BUILDING PERMIT APPLICATION Existing Use of Building: 3-M�r-F �"S Contract Price of Work:$ "1 U�� Proposed Use of Building: Sf�-svtE Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Projecf: ❑New C7Addition ❑Remodel ❑Repair ❑T.i. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: . ASSOCIATED BUILDING PERMIT#(if applicable): ��v i � '-'� �X�� V�h-��5��" `� , 7ti"'�� MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair Fixfures V�of Fixtures Fixfures List of Fixtures #of (.�st of Fixtures #of Lisf of Fixtures 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/BaNMop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water No.of Heads ACKNOWLEDGEMENT.•!have reviewed this applicafion and confirm the information contained herein is true and correct.Work done pu�suant to this permit must comply with current federal,state,and local law.The granting of a permit only aufhorizes approved work and no deviations therefrom.Deviations must frrst be aufhorized in writing from the Building O�cial before being aufhorized under any circumsfance.1 am the owner,orl am authorized by the owner of this properfy fo perform the work for which application is made, and 1 compfy with the State Contractors Law 98.27 RCW and 296.200A WAC. City of Everett O�cia!Use Only ` � ��- �� PE I � �,��'' ��.. OwnerlAuthorized Agent Signature Date (Revised 9/23/2096) /Z