8907 W MALL DR 2018-05-22 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� w�wv.everettwa.gov/permits (Blue or Black Ink Only Piease) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: O7 (�I M��-L D� EUErZ,�r� � PROPERTY TAX#: LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Q G� LZ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReer LJ D 7 � �` 12 CITY E �T STATE ZIp ��Z O OWNER PHONE: 25']3� 2, �i OWNER EMAIL: CONTRACTOR NAME: �J �� CONTRACTOR ADDRESS: srReer 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 Buildin : �,�S1Q� I L Contract Price of Work:$ 9 Pro osed Use of Buildin : re sl -N / 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: o �z.o�o �� U MCa✓ �� o� �S ��- � !23 �n-r�� 5 c/�pl�v c�yb v�,o� 42.�/Uc/�,c�y �� (/'��`��" °►� �-S 'rc �G e- /� C�� � � �s 9 -� � ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New Addn Alteration _Repair Type of Project: New Addn _Alteration _Repair Fixtu es List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of 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 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 on/y authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building O/ficial before being authorized under any circumstance.1 am the owner,or I am authorized by the owner of this property to pertorm the work for which application is made, and I comp/y with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only � , PERMIT#� , � � �e(/�. �,v-�� I , ��,. --�, , . � ,� , �; � .i� Own r/ ut orized Agent Signature D te (Revised 9/23/2016) ,