723 LAUREL DR 2018-07-18 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 4117j":4- 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 ( FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) =PROJECT`SITE INFORMATION -,r'; ri K PROJECT SITE ADDRESS: 7Z 3 Z.049 u oe L 1 T v-' PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION , OWNER NAME: g`(q.A` Ni //L.'2 / TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET P lgou / 2 IOU L CITY EOgVe22# STATE Zeitiq ZIP 9dzo6- WNER PHONE: /Z C C/ZZ ZffZ OWNER EMAIL: CONTRACTOR NAME: SE /—P 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: BUILDING`'PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use /DESCRIPTIONOF WORK: s Cn/4�,/ vy 04 9 (4 f#Liir4tgQ IL Jep!wc2 w, p ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION , '+ ,PLUMBI, PERMIT APPLICATION Type of Project: New _ Addn _Alteration _Repair Type of Proj _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 2_ Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal _Gas Piping Boiler Z. 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 HoodWater Heater Other: Exhaust Fan f Sink(Service/Bar/Mop/etc.) Other: ! SPRINKLER SUPPRESSION SYSTEM.; 111 Number 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 th State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only b1/1/61 ,- 101s---// PERMIT#/ [ toID �coZ Owner/Authorized Agent Signature ate (Revised 5/20A016)