724 LAUREL DR 2018-07-18 - Laserfiche WebLink

IT APPLI BUILDINL VIECHANICALEI PLUMBINGI /CS GN 1 RINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 04217 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please)) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: V - 2 ace/ D}e PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION 5y OWNER NAME: leo 0//e y V4+6O4/ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 7�2 4/ 2.7,/ye/ /0,/'� CITY /,.� / Y l� STATE �,/2, ZIP 4,r2,2-,/ OWNER PHONE: 760— 51 e— 90V 9' OWNER EMAIL: (J)1'n&pe,./�,4 3�_Coyne-�S Iedlef 40t' CONTRACTOR NAME: C hay./es J y//�jof s U j'( �e�� — ,(/�� L CONTRACTOR ADDRESS: STREET l 2)O L„,,, ?I ,---; r ifet 7 c,F \t 4 � CITY L .:4,er $ WI- C� STA E ZIP CONTRACTOR PHONE: 2 0 6-3.72-2767 CONTRACTOR EMAIL: Char/es 2o ,�r n CONTRACTOR LICENSE#(REQUIRED):'o(E l u\ \ CITY OF EVERETT BUSINESS LICENSE#(REQUI D): r G!„�4"2� PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) � /`t'CONTACT NAM : �, CONTACT PHONE: 360-`j l g'- 9:09' 11 9Cfi a r e y !U trr de.} CONTACT EMAIL: -' eive 4 '6 o c 1 /‘,„...7 co A/cgs- a/ e— BUILDING PERMIT APPLICATIOor 0 Existing Use of Building: Contract Price of W Proposed Use of Building: Heat Source: ❑Gas DElectric DOther Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: DCommercial ❑Industrial Type of Project: ❑New DAddition DRemodel DRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ,Kevn Le /orC1t ye?<> aha' cafeC� ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATI Type of Project: New_ Addn _Alteration _Repair Type of Project: _New _Addn __Alte on _Repair #of List of Fixtures #of Li -of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtur NC—Air Handling Units ., eat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Bas'.- Drinking Fountain Water Heater Refrigeration Shower Floor Drain _ Gas Fireplace Wood Stove Kitchen Sin Disposal Grease Trap Gas Range Ducting Dishwass-r Roof Drains Clothes Drye. ookups Other: Cloth:'Washer Medical Gas Range Hosi W-er Heater Other: Exhau, an t nk(Service/Bar/Mop/etc.) Other: S INKLER/SUPPRESSION SYSTEM Chemical or Water I No.of Heads ACKNOWLEDGEMENT:1 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 Official Use Only PERMI 7/ (--)//digt9e("1 Z c_i 05 _05(10 Owner/Authorized Ag Signature Date (Revised 9/23/2016) -"-'-•\ 7 ,