4021 FRIDAY AVE 2018-05-16 - Laserfiche WebLink

��i��Lic�rior� �ui�.�a�� c�,��Ac�� u��ir�� si�� i��.�� Mo�t�so� 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 �lack Ink Anly Please) PR�JE�T SITE INF�RMI4TION PROJECT SITE ADDRESS: �LI ��" A'�• �V�✓� �t/�- 9B74f PROPERTY TAX#: �¢G��a �O� 94�' LEGAL for new construction: Short PlaUsubdivision Lot No.__ (attach copy of long legal description) COtdTAC`T I�IFORMATIOPI OWNER NAME: h'Ii��p Itlr��cV TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReEr '�OT� ��ida f�`�G CITY � �NL� � ST°TE /�/ 71P /GzO� OWNER PHONE: ZOG y7�( -/S�Z OWNER EMAIL: w1��P`��w�w C� Gbw�G.��'11t.� CONTRACTOR NAME; �atitc6 �1tMnbiµ CONTRACTOR ADDRESS: sTREEr 3(Q l/ 1'V1G��h I CITY � STATE vV� ZIP /�fG CONTRACTOR PHONE: �Zo4 4'L3 - �t4S� CONTRACTOR EMAIL: t,�o�v�Go � ZOIG �'' wt�.�I• G� %', ; CONTRACTOR LICENSE#(REQUIRED): �A/�CO{'G b"fd-D� CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):?' % PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR �OTHER(Please Specify) rJ GGf l�9*vta CONTACT NAME: CONTACT PHONE: �`� //' 92S � ` 3`zt�: �� �P/Y?/� SI�ZtMR'yy CONTACT EMAIL: t� i�2tM�tNN 'C��Sy-Gt)ty� BUILDING PERMIT APPLICATION /,- Existing Use of Building: Contract Price of Work: $ zi ��v � /� Proposed Use of Building: Heat Source: ❑Gas ❑; lectric ❑Other' Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commer ial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑ molition hange of Use DESCRIPTION OF WORK�� a�� /� � �7 f ��v /�/\ N�d /�� /'�1 iF�LtKq � �J �. � ./ �I�Q�-- _ 03 �- ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New Addn _Alteration _Repair Type of Project: _New ZO Addn _Alteration _Repair #of List of Fixtures #�f Lisi of Fixtures #of List of Fixtures #of List of Fixiures Fixfures 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 Z. Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Z Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSIAN SYSTEM Chemical or Water No. of Heads ACKNOWLEDGEMENT:I have reviewed this applicafion 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 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.I am the owner,or I am authorized by the owner of this property to pertorm the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only . � ` a - 17 PERf�I�� _ ooz awn r/Authorized Agent Signature Date (Revised 9/23/2016)