5621 SEAHURST AVE 2018-06-27 - Laserfiche WebLink

OXTPERMIT APPLICATION BUILDING /MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 5 ) l•-\ Si' A F -PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: •Rf-IC1r1`I it I Q I/(a ZnktbEtyANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5Sectkj cs t Ave-. CITY fU'erc_ , wa 1 STATE („.() 1 i ZIP le2as OWNER PHONE: (-1,„.1S- —3 Li . 201.,,. OWNER EMAIL: qaL/fct _`Z.t'n L/ CONTRACTOR NAME: 1-c (oa n-ec CONTRACTOR ADDRESS: STREET fume, CIN STATE ZIP CONTRACTOR PHONE: ,\ic,,_ CONTRACTOR EMAIL: a (' CONTRACTOR LICENSE#(REQUIRED): IR I CA.... CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): fl I PRIMARY CONTACT: SA OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Lfa-s -3L f b_2', (Q a/lQ a flocifocelinfokl CONTACT EMAIL: 4a-WiAck__4'n kms)p ya o1co r BUILDING PERMIT APPLICATION 1 Existing Use of Building: Contract Price of Work:$ 0 4- IYIa. rt4 I "-S00.00 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New DAddition ❑Remodel ❑Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: hike AcR a cia --"- 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 #°f List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal 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: -I Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan 1 Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/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. r� City of Everett Official Use Only r /0 PER T \�l 0 — o02Owner/Authorized Agent Signa 'e Date (Revis d 9/23/2016)