10501 29TH AVE SE 2018-05-02 - Laserfiche WebLink

III II PERIVi1T l�PPLIC/�TIO �llIL.D1�7�VIECH�aNICA►L/ PLUIVIBINC� /SIGN��FtINKL.ER/ 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 (Blese or�lack Ink Only Please) PROJECT SI'rE IIdFORMA7'IOlal PROJECT SITE ADDRESS: �OSO/ ZQ��ti�% S� ��/Can�T7 PROPERTY TAX#: LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTRee-r CITY " STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME; Od��Q I�CS /�k�7Kt..J�'ST CONTRACTOR ADDRESS: srREer Z��O ((�r �� S( NGG ciTr �'� ST�vd+�S STATE L�J�' ziP `I�ZS� CONTRACTOR PHONE: ZOCv 7r� �{g3 t CONTRACTOR EMAIL: S�� t7O�wO/j1E t�LXl�Q'7�'�T.C�— CONTRACTOR LICENSE#(REQUIRED): �ZO�r�'�N��Y �� CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):�Z� PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: QOCq '��'Y?3 / ��G'� CONTACT EMAIL: s�h d�p�,r,��kf�g7�4�7, c� BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Buiidi : Heat Source: ❑Gas ❑Electric ❑Other Building Type: FR-Detached ❑SFR-Attached ❑Dupiex ❑Multi-Family�#of Units: ❑Commercial ❑Industrial Type of Project: ❑New �Addition emodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ��D� Cc�� co�� oN ASSOCIATED BUILDING PERMIT# if ap licable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLIC/ATION Type of Project: _New Addn Aiteration Repair Type of Project: _New Addn _Alteration _Repair #of List of Fixtures #�f list of Fixtures #�f List of Fixtures #�f List of Fixtures Fixtures Fixtures Fixtures Fixfures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bidg) 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/Bar/Mop/etc.) Other: SPRINKLER!SUPPRESSIAN SYSTEM Chemical or Water No.of Heads ACKNOWLEDGEMENT.�1 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 local law. The granting of a permit oniy authorizes approved work and no deviations therefrom.DeJiations must first be authorized in writing from the Building O�cial before being authorized under any circumstance.l am the owner,or I am authorized by the owner of this properfy to perform the work for which application is made, and I com ith the State Contractors Law 15.27 RCW and 296.200A W.4C. City of Everetf Official Use Only _.. . � Og /Z�� PERMIT l 7J(/ 1 J��/� l ( OwnerlAuthoriz Agent Signature ate (Revised 9/23/2016)