2413 HILLSIDE LN 2018-05-29 - 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� www.everettwa.gov/permits (Blue or Black Ink Only Pleasej PROJECT SITE INFORMATION PROJECT SITE ADDRESS: Z� � �'i' ��3 PROPERTY TAX#: 5 �1 OO � Oo�L LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: �—� �jG,r bc�(0. C�V 1 C TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srraeer 2 �� v e v c sTATE � Z�P OWNER PHONE: Z.rj- Z,3 � - OWNER EMAIL: �(bGy�d Y C' n CONTRACTOR NAME: I�C S}er1'� n C . CONTRACTOR ADDRESS: srREEr Q A C�N 1 I �n �0.,n�. STATE w,It Z�P 8�.a� CONTRACTOR PHONE: - �g CONTRACTOR EMAIL: C Q � �j� o�N 'I�C• CO'M CONTRACTOR LICENSE#(REQUIRED��/{/�S 1�S�C 9 � 3 O CITY OF EVERETT BUSINESS LJCENSE#(REQUIRED):U� I PRIMARY CONTACT: ❑OWNER ,�CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ,'�y �U q ��e�f "'''�t�' CONTACT EMAIL: Ch,e,,- Q �{ ��.C BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work: $ t V g5 CSU 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: ��"1S�'Gt.�� sd�U.✓ �v S�S'�fY1 ASSOCIATED BUILDING PERMIT# if ap licable : MECHANICAL PERMIT APPLICATMON PLUMBIN6 PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair #of List of Fixtures #of �st of Fixtures #of List of Fixtures #of List of Fixtures Fixfures Fixtures Fixtures Fixture A/C—Air Handlin Units Heat Pump Toilet Backflow Preventer Inside Bld Forced Air S stems Unit Heater Bathtub Urinal Gas Pi in Boiler Lavator Wash Basin Drinkin Fountain Water Heater Refri eration Shower Floor Drain Gas Fire lace Wood Stove Kitchen Sink&Di osal Grease Tra Gas Ran e Ductin Dishwasher Roof Drains Clothes D er Ho ups Other: Clothes W er Medical Gas Ran e Hood Water H ter Other: Exhaust Fan Sink ervice/Bar/Mop/etc. Other: SPRINKCER 1 SUPPRESSION SYSTEM Chemical or Water No. of Heads ACKNOWLEDGEMENT:1 have revrewed this application and conh'rm the information contained herein is t�ue and correct. Work done pursuant to this permit must comply with current federal,state,and loca/law. The granting of a permit only authorizes approved work and no deviations iherefrom.Deviations must(irst be authorized in writing from the Building Officia!before being authonzed under any circumstance./am the owner,or 1 am aufhorized by the owner of this property to perform the work for which application is made, and I comply with fhe State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett 0lficial Use Only �� PE I # �� ,�� OwnerlAuthorized Agent Signature Date (Revised 9/23/2016)