4403 RIDGEMONT DR 2018-06-27 - Laserfiche WebLink

OLTPERMIT APPLICATIOlL BUILDING/MECHANICAL/ PLUMBING I SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 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 Only Please) I PROJECT SITE INFORMATION PROJECT SITE ADDRESS: y y D3 Rig dae ry)p r7�'' Of, PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision �J Lot No. (attach copy of long legal description) CONTACT INFORMATION 4 OWNER NAME: in Q('K C, 15 p of TENANT NAME(If Commercial): --- OWNER MAILING ADDRESS: STREET „jQJyy‘..C_ CITY STATE ZIP OWNER PHONE: (-425- -7 5 0 - Z a 9 7 OWNEREMAIL: lk CONTRACTOR NAME: Ivor'-hterrn o,ss'hi u G(j/ni V- efry)Oeie/, j fu e'_ CONTRACTOR ADDRESS: STREET "' t)q ✓YI e 771 / kc /'a 7iG Yu (� CITY / t a...I i (3 STATE / 0+ ZIP 2' if 7 / CONTRACTOR PHONE: 020(p - y 1 f--Q 6,S 2 CONTRACTOR EMAIL: /14.r be rh-e',o^ 9 eta I. CIU m CONTRACTOR LICENSE#(REQUIRED): ND Oh(3 r 0 a y Q CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER RiCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Cj 6 - y/ 9 ._ o t/ S Tey14 iga/139 e v--- CONTACT EMAIL: C r bee._N h-t? 9 a.p I , C'c BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas 0 Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: ❑New ❑Addition ,Remodel ❑Repair DTI. ❑Sign ❑Sprinkler El Demolition ❑Change of Use DESCRIPTION OF WORK: 1 ,. I c� i Ad V, i / tL p016C 1 00 P,`Pep ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION 1 PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn 'Alteration _Repair #of #of List of Fixtures List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump .0. Toilet ,.8- Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater 2 Bathtub ,.--- Urinal Gas Piping Boiler 3 Lavatory(Wash Basin) L Drinking Fountain Water Heater Refrigeration ?j Shower .._43-- Floor Drain Gas Fireplace Wood Stove / Kitchen Sink&Disposal ...gpGrease Trap Gas Range Ducting / Dishwasher _19— Roof Drains Clothes Dryer Hookups Other: J Clothes Washer ..,..0- Medical Gas Range Hood / Water Heater V) Other: Exhaust Fan _"Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water I 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 OfficialliaUse Only '71. i / `j�'? b.? PERMIT#�ii 0 ✓ /"� Owner/Autho 1�'•d`en Signature Date (Revised 9/23/2016)3