1600 MADISON ST 2018-05-22 - Laserfiche WebLink

��ni��,��ac,��raor� �u0��irv� i ��c�An�ac�,�� Lun��ir�� sa�� i ��i��i ��noLo�rio� 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.govlpermits (�lue or �lacic In4c �nBy Ple�se) PROJE�7' SI"9"E IWFOFtMATION PROJECT SITE ADDRESS: �c�/ � PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) COIdTACT IN�ORMATIOP�I OWNER NAME: L. -y c �� C�t",'Z' TENANT NAME(If Commercial): .r'�,� c.• -��..;,, �� OWNER MAILING ADDR SS: STREET - ��v,�,�,- CITY - STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: �'i L,�i�=�= ,Z_-- CONTRACTOR ADDRESS: sTReer �� -� �;�I�,`��, CITY E;L� . '7 .^ STATE�:V"� ZIP ��z��J �j CONTRACTOR PHONE: Z - S CONTRACTOR EMAIL: ��F,L� � � " ��,��,�-{--�— a . c- CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ;J � r�{,�J CONTACT EMAIL: BUILDING PERMIT APPLICATION — �' —�� Existing Use of Building: Contract Price of Wor $ — Proposed Use of Building: Heat Source: ❑Gas E ec nc"""-"'B'Of�er��J Y f 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: I )Z--%;�._r�L-�� t�-%�=c�,r� � � ) �___�-�- �,-�/ -Z_ }—q�-;��,_ � ,s. ;� � I J ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLIC�TION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of Lisf of Fixtures #�f Lisf of Fixtures #�f List of Fixtures �°f List of Fixtures Fixtures Fixtures Fixtures Fi�ctures 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/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Chemical or Water No. of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the informafion 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. 1 am the owner, or I am aufhorized by the owner of this property to perform the work for which application rs made, and 1 ly with he State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only - I � I 3 �� PE� � `'r 5 Owner/ thorized Agent Signature Da e (Revised 9/23/2016) �, �