909 GRAND AVE 2018-06-07 - Laserfiche WebLink

PERMIT APPLICATION "IIIIPBUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION 4141 g.1- CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits . �:_} t ,,. �� 'rte, � : ��s x �� fir'"�� 40440 h?`a., . X N„ . �v !,6.. , ."3 ,s r.:; a'rte e y5 '.".. PROJECT SITE ADDRESS: 709 eiv,id 4-i,? CLCc //41 9 9Vc/ PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) OWNER NAME: �eif,rc TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 904? ey ,7d Ae_. CITY fve-re.174 STATE Z444 ZIP 9g`.20 OWNER PHONE: 340 --o� 9 r _7i, QL OWNER EM L: CONTRACTOR NAME: 14/12 / p/(im ,yi CONTRACTOR ADDRESS: sTREET /73„? 1 % e S 7- t` - 4, 7)2on ro C. CITY , C ftr)C STATE Will ZIP 9V 7,2 CONTRACTOR PHONE: lii 36 )-7t?L/ n a I C TRA R ,i• L: 44 ike gAia// P i , c:,,r) CONTRACTOR LICENSE#(REQUIRED): AID/J'e PT 03 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):3-26 7O PRIMARY CONTACT: ❑OWNER g216ONTRACTOR 0 OTHE' ''le e Specify) CONTACT NAME: (�^, CONT• T PHONE: y2S-3�'�'�7—29a.? ✓)')1r11-.e /4.7)nLinz,)4 A4 ( ONT'CTEMAIL: M ir1e/7�/ 4' Lt/aayi , c„,Ili Existing Use of Building: (es,4e/-ee Contract Price of Work:$ 76)90,e Proposed Use of Building: A e S,d Cri c : Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attache ■ I •le ❑Multi-Family-#of Units: ❑Commercial . ❑Industrial Type of Project: :New ❑Addition L emod= ❑--.air ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Amde� - ! iii,Ato&41 ii ASSOCIATED BUILDING PERMI #(if ap icabl-. Type of Project: _New _ Addn Alteration Repair Type of Project: _New _Addn Alteration _Repair #of List of Fixtures °f Li- of Fixtures #°f List of Fixtures #of List of Fixtures Fixtures FI res Fixtures Fixtures NC-Air Handling Units Hea Pump _'Toilet —Backflow Preventer Inside Bid• Forced Air Systems Uri Heater _'Bathtub —Urinal Gas Piping : er `an 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: `mo 2 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.lam the owner,or lam 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 PER TOW \ 9- 0— 00 9 Own Au 6rized Agent nature •Date (Revised 9/23/2016)