2409 W MUKILTEO BLVD 2018-06-07 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/ PLUMBING I SIGN /SPRINKLER/DEMOLITION �I ►':-, `"A CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-88117E FAX 425-257-8857 1(E)everetteps(c:$everettwa.gov I www.everettwa.gov/permits (Blue or Slack Ink Only Pleasel.� . PROJECT SIT!INFORMATION di PROJECT SITE ADDRESS:ai d 9`�pi V,µ4/;ft1fo 6 1 vet PROPERTY TAX#: d D 1 17 etel0 D/,3D O LEGAL for new construction Short Plat/subdivision Lot No, (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: -17Q 1 S MLA M if It it S e V TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 9A lr0� 3 "*,51-- my 1'l td.1 i ire f7 STATE /,tIC_ zip 94a 75- OWNER 5-OWNER PHONE: 'OWNER EMAIL: /� CONTRACTOR NAME: I?/1,/ it, �j'f bel eedi tl "f' SA eel' /y1etea rj•IL. I CONTRACTOR ADDRESS. STREET /'i / c75? dcg 3 /3/4+A✓t N g cm La-ke_ Ste✓e N 5 STATE A.,/a,_, ZIP 9galye CONTRACTOR PHONE:4?S.-.33- - TAQ 7 CONTRACTOR EMAIL: r I( tcto A 1 e th Al(J--on Ne .Co M. CONTRACTOR LICENSE#(REQUIRED):i4/6/I r')s'/y qg3 e..441. CITY OF EVERETT BUSINESS LICENSE EQUIRED):0 3941 PRIMARY CONTACT: ❑OWNER XCONTRACTOR 0 OTHER(Please Specify) Ma- /< G i ps o P1 - leas-'731/-$js/ CON AAC,T NAME: (S e'e or-'o 11 e) o,e CONTACT PHONE: d t. 'a c— IA.5 335 J/0,D 7 CONTACT EMAIL: �(t,, rr 4,k to vt �e a fr H (�T�r'o to i e✓',c OM BUILDING PERMIT APPLICATION Existing Use of Building:j F 'Re S. Contract Price of W rk: _ Proposed Use of Building: Heat Source: ot4as Building Type: JitSFR-Detached ❑SFR-Attached ❑Duplex ❑Multl-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition gRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use . DESCRIPTION OF WORK: j L rst i�rp, h9' — J OuT(�.�5 IJ ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMITAPPLICATION -. J :PLUMBING PERMIT APPLICATION s Type of Project: New_ Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair Fixtures tat of Fixtures Flu oxtf List of Fixtures 0 of Fixtures List of Fixtures 0 of Fixtures List of Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal 3 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 I INo.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 Bulking Official before being authorized under any circumstance.lam the owner,or I am authorized by the owner of this property to perform the work for which application Is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only /-647- 17 P # 1 jwlAuthorlzed Agent Signature Date (Revised 9/23/2016)