2221 LOMBARD AVE 2018-07-18 - Laserfiche WebLink

PERMIT APPLICATION■ #11P/14,vBUILDING / 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 I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 22_21 Lo M f3A)2.,0 Pry Fr S V E ge`-T PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: D t 1.-6 G Tte•-k r-\-LA TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2.4 00 (.4,2AAA Ave S' j it- CITY lirkjft e-t,( STATE IA ' ZIP 9g6 2.4OWNER PHONE: LF-�S 78S" 752..3 OWNER EMAIL: LJ J LE of d t"t t�1,,b- V4 ` co Al CONTRACTOR NAME: P Fe-T R- E T LV-M ,6 l NI6) t INC (Sl1 1SSEC.g612 C-, CONTRACTOR ADDRESS: STREET /'t3 jq u->EA/ Pt_ CIN -EV 9 Tr STATE WZIP eg L0j CONTRACTOR PHONE: -2,q-3---60 ' CONTRACTOR EMAIL: . PE ca Al)tt • . mai CONTRACTOR LICENSE#(REQUIRED): ' ,or fCITY OF EVERETT BUSINESS LICENSE#(REQU ED): `,/ ♦ b PRIMARY CONTACT: 0 OWNER z CONTRACTOR 0 OTHER(Please Specify) -........1,��ji. CONTACT NAME: Sn"P"( ISS ELaE c--) CONTACT PHONE: 4-2-5-,--2733 60,x'9' Z. 2 r- CONTACT EMAIL: .p i pi~Te P-e a wic I BUILDING PERMIT APPLICATION .=--`� ..` Existing Use of Building: Contract Price of Work: U f)i/ Proposed Use of Building: Heat Source: ❑Gas 0 Electric Other __/ Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex DMulti-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition DRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: _.,-4 /Re/9/44rpm G)`/.7 1 ASSOCIATED BUILDINGERMIT#(if applicaktt : MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration )( Repair Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures A/C—Air Handling Units Heat Pump 2• Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater cid Bathtub Urinal Gas Piping Boiler 2. Lavatory(Wash Basin) Drinking Fountain _ Water Heater Refrigeration 2. Shower Floor Drain Gas Fireplace Wood Stove 1 Kitchen Sink&Disposal Grease Trap Gas Range Ducting I Dishwasher Roof Drains Clothes Dryer Hookups Other: I Clothes Washer Medical Gas Range Hood I Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER I SUPPRESSION SYSTEM Chemical or Water I 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.lam 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 YJY//fr. ..i 6q( At y J VPERT�bjk r)-(DS ` O i 1 Owne Authorized Agent Signature /6ate (Revised 9/23/2016)