6431 CYPRESS ST 2018-07-24 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/ MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION Nitica CITY OF EVERETT PERMIT SERVICES 3200 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) ` . PROJECT SITE INFORMATION PROJECT SITE ADDRESS: (9'4431 - CAAT ILIA' l PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION' 9 telt 14 TENANT NAME(If Commercial): OWNER NAME: 'paV�Ca '�,, ��t,,t"� �K,,�.��,.�/�„�I __ !! OWNER MAILING ADDRESS: STREET A r 4`L CITY STATE ZIP OWNER PHONE: (OWNER EMAIL: CONTRACTOR NAME: 1-W ON`¢ ik1 + „�kr.,....--„} CONTRACTOR ADDRESS: STREET ''''.7 1/ _1 /3 CITY.. 0 LA444 ax. f1 STATE L ZIP a a CONTRACTOR PHONE: �'/J,,a -t ' 431, P3 (CONTRACTOR EMAIL: &Le'((tel, ‘@ ' ,< ' `gp a CONTRACTOR LICENSE#(REQUIRED):,'M lei P'1 ICITY OF EVERETT BUSINESS LICENSE#(REQUIR-•):05-1/s Z PRIMARY CONTACT: 0 OWNER VCONTRACTOR 0 OTHER(Please Specify) CONTACT NAE: CONTACT PHONE: Z,,,(0 s'Jc5 „�.31]C'?> Ulkaft tC. CALP01 CONTACT EMAIL: A l a r ' -,. i - [ti ril. if ' . BUILDING PERMITAPPLICATION Existing Use of Building: Contract Price of Work:$ V 000 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 ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: C2AR'1--#4 \4,D rl•-•'/O 4-U-."'C-S ---0‘-Z ./(kWYNs1-11/40V\.- 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 Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures NC-Air Handling Units ) Heat Pump Toilet Backflow Preventer(Inside Bldg) 4 Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater r Refrigeration Shower _ Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range I Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas ItRange Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/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.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 1 '' I I . 6-ii-/ P T V S — o�\3 Owner/Authorized Agent Sign• ure Date (Revised 9/23/2016)