8120 BEVERLY BLVD 2018-05-29 - Laserfiche WebLink

PERMIT APPLICATION BUILDING I MECHANICAL/PLUMBING I SIGN/SPRINKLER I DEMOLITION 477CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits _- :.. PROJECT SITE;INFORMATION PR011 gT�iTE ADBFg.: ` Li n PROPERTY TAX#: LEGAL for new construction: Short Plat/stlbdivision IJ Lot No. (attach copy of long legal description) •. a: ' CONTACT INFORMATION; „g OWNER NAME: ? .p p�0 14�//r'� TENANT NAME(If Commercial): 't OWNER MAILING ADDRESS: STREET Et 2c� t3 e c- E j jG, V D CITY V�Q --L4 l! STATE LAJC6' ZIP ZG 3 OWNER PHONE L-(2-� 3 S`jaS OWNER EMAIL: b©ce Z (J CONTRACTOR NAME: C.) 'W CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT:Al-OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: t-( 2c 3 c--c— 4-574, LL CONTACT EMAIL: y.b 0 e z l/ i1 t¢� . ce- 7 R > F S BUIILDINGtPERMIT.APRUCATION __ `., ,.. . .. ___.. _.._: Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas DElectric El Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family #of Units: ❑Commercial Dindustrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair CIT.!. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION „ . ,,.f.: PLUMBING?PERMITsAPPLICATION.`, „_ Type of Project: New _ Addn Alteration Repair Type of Project: _New _Addn Alteration Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f 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;; 1 Number 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 onty 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 1 am authorized by the owner of this property to perform the work for which application is made, ,.mply with the S• • actors Law 18.27 RCW and 296.200A WAC. / { City of Everett Official Use Only 12-3 7 PERM 0s- -0U wner Autho ized Agent Signature Date (Revised 10/12/2015)