3530 FEDERAL AVE 2018-06-07 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES . 4.7_,_ 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink OnlyPlease) PROJECT� SITE INFORMATION PROJECT SITE ADDRESS: 3$ 3 (� � /moi C PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: -1-�/",.q S TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3 r 3 U Fe AI 4-L,-� CITY EJ C(,L 51 " STATE I/Ar ZIP d Q OWNER PHONE: Li 102 5 1 gl S C. "?t-( OWNER EMAIL: CONTRACTOR NAME: (I o?.'\ PHM b CONTRACTOR ADDRESS: STREET 17 f L/) tf 5i SC CITY cjt p ti a G'u.(`, STATE w Ps- ZIP Y2-4i U CONTRACTOR PHONE: c-./2 S 7 64) E�G v CONTRACTOR EMAIL: j r'e rt-- cI h o en /�.,, 1-7. G e, CONTRACTOR LICENSE#(REQUIRED): OL.A PPG 65-1 M t CITY OF EVERETT BUSINESS LICENSE#(REQUIRE . 05 L jc,/ PRIMARY CONTACT: 'OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: l c ?6 o �-3 C 0 Pif-,(r,4- /I .2‹iN CONTACT EMAIL: 7 -y,,,y- c, f,..�e.....L„ , c..BUILDING PERMIT APPLICATIO Existing Use of Building: Contract Price Work:$ 7,, r--1. — Proposed "'Proposed Use of Building: Heat Source: Gas DElectric ❑Othe Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ommercial El Industrial Type of Project: :New ❑Addition ❑Remodel ID Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: locrksCe_- c,,,,}- (rc—i sh II., -A5 I �.2 d—,-, ritnb ,;-d-e SL.,,".</ 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 #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump 'L Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler )< Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration X 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 I 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 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.I am the owner,or I 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 ---7-7 5-- 3t— � -� PERM � I#1o�'�2Z Owner/Authorized Agent Signature Date (Revised 9/23/2016)