6229 W MAGNOLIA AVE 2018-05-22 - Laserfiche WebLink

PERMIT APPLICAT"f�E �UILGo��: / MECHANICAL/ PLUMBING / SIGi� i ,�PRINI'rKLER/ DEMOLII"ION 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 Ink Only Please) PROJECT SITE IPIFORMATIORI PROJECT SITE ADDRESS: � - p�, ' �.�� PROPERTY TAX#: LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACY INFORMATION OWNER NAME: � �� r �, �S J�� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREET � ,� �� . �, �� CITY � ,. � , � � STATE 'j'� ZIP ,/ � OWNER PHONE: '✓`�,J- � � OWNER EMAIL: �v/�.L � C � � � G `��/�. - CONTRACTOR NAME: — �_.� CONTRACTOR ADDRESS: srREET CITY 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: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$_ � �- , Proposed Use of Building: 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: � r� •�� ,� . , �d �T,P_�02_ �-r:�.�� JZ��. -- _ _ i - -_, 2�:�c 3 �j � �. _ ...,. I ASSOCIATED BUILDING PERMIT#(if applicable): � v MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of List of Fixtures #°f Lisf of Fixtures #of List of Fixtures Fixtures 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/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water No. of Heads ACKNOWLEDGEMENT:I have reviewed this applicafion and confirm the informafion contained herein rs true and correct.Work done pursuant fo this permif must comply with current federal,state,and local law. The granting of a pe�mit only authorizes approved work and no deviations therefrom.Deviations must first be aufhorized in writing from fhe Building Official before being authorized under any circumstance. I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PE IT# � � � �� • � � Ow e�lAuthorized Agent Signature ate (Revised 9/23/2016)