10617 ROSEWOOD AVE 2020-05-05 - Laserfiche WebLink

NM PERMIT APPLICATION BUILDING , .4IECHANICAL I PLUMBING/SIGN I`.?RINKLER/ DEMOLITION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blu or:B(ack.ilnkOnly,Please) PROJECt_SITE INFORMATION., , 1 i ' 5 PROJECT SITE ADDRESS: sr,j i(7 '. AV F -V PROPERTY TAX#: Q r5 L q);2)0{7Uuj LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ,; . CONTACT-INFORM4T1O.N l/� OWNER NAME: p, ' ' I(11ilhifi)/ / TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET ,T Z ,1 b I'll ( L S L I CITY Q'' ,ikSTATE LA.* ZIP q s 2.0 r OWNER PHONEt 3161 0 3OWNER EMAIL ( o 1ha,LAIC. l`v' i �1► 1.,a6.041 CONTRACTOR NAME: ( J/1er CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: . OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE ( Za 3/4i -0 3 33 1� 1 CONTACT EMAIL: / Ut� �U K i) l(lar il, 4,,,,[4. .a00 2�r- ,�,1 l 666 .. 'SUILDI:NG INFORMATION . Existing Use of Building: f Contract Price of Work:$ �i-000 Proposed Use of Building: Heat Source: ❑Gas ❑Electric . ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units:_ ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 17) V61110 CX' S l')tii 14010:le i Mei ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICALi;PERMIT APPLICATION.,:> . PLUMBING PERMIT.AP:PLIC4TION` _: Fixture Fixture Fixture Fixture Count List of Fixtures Count • List of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop. Exhaust Fans(Residential) Commercial Ventilator Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 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 a •prized 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'Co, .o•s Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# _ • / (:) (7 7 0//? i Cl Os —00L-I Owner/Authorized Agent Signature Date (Revised 4/15/2019)