723 LAUREL DR 2018-07-18 - Laserfiche WebLink

PERMIT APPLICATIO= BUILDING /MECHANICAL/ PLUMBING /SIGN /SPRINKLER/DEMOLITION mila� CITY OF EVERETT PERMIT SERVICES I3200 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) F;` , PROJECT SITE INFORMATION N ,, LPROJECT SITE ADDRESS: 7 2,2 1-.14 u i f L b >- - PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: iiL /6,9 i 04,L t tom— TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 41)0 D X Q G C �_ /CITY STATE ZIP OWNER PHONE: '---(2cr2c `-CZE 2 9. a-"- OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: ,� __ x BUILDING;PERMIT APP LICATION ; Existing Use of Building: Contract Price of Work:$ 0000• 9' Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use /DESCRIPTION OF WORK: lit (14 c j — t - 9` -t . -- to t` ,---- OIL C ASSOCIATED BUILDING PERMIT#(if applicable): V 1 (%�/) Y MECHANICAL„PERMIT APPLICATION `. ,PLUMBING PERMIT'APPLICATIO _ Type of Project: _New_ Addn _Alteration Repair Type of Project: _New Addn Alteration Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump 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: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: L„,H_, SPRINKLER I.SUPPRESSIO_ N SYSTEM„, _, Number of Heads __. ACKNOWLEDGEMENT:I have reviewed this application and confirm • " .mation 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 perm' ^ authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before b g authorized under any ci^• stance.I am the owner,or l am authorized by the owner of this property to perform the work for which application is made, and I comply with th. -Contractors La 18. -CW an./ 96.200A WAC. 4iii I I City of Everett Official Use Only ,��4 '1 PERMIT #1?)i sI2foZ1 Owner/Authorized Agent Signature Date (Revised 5/20/2016)