1303 W MUKILTEO BLVD 2018-12-21 - Laserfiche WebLink

PERMIT APPLICATION "111P'404/ 4 BUILDING /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 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:/3e>3 LW mu/dura 3Li'Ur gV,E7 77'./j//) V2.03 PROPERTY TAX#:0062,570000/102 LEGAL for new construction: Short Plat/subdivision Lot No. / (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: % 4 CEGiLiA /AVItc- E TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET}/I,03 W }'1 vtaL,-••EG p cm( p. 2,*`T vJA) otgzo, STATE ZIP OWNER PHONE: t0(19t0(19r q 11 wf, OWNER EMAIL: CONTRACTOR NAMF.L,__.---- 134 * 0i (FL__) 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 nrOTHER(Please Specify) /?P L) T / P>fr71(„/NF_IL. CONTACT NAME: 4",_, CONTACT PHONE: Mr q *)Z. (t t (.42V1 CZ CONTACT EMAIL: A(,G 4 w `h)y Q .,L'j BUILDING PERMIT APPLICATION 1 Existing Use of Building: lj(f Contract Price of Work:$_ 1iO, 000- Proposed Use of Building:g: Y(� Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial [Industrial Type of Project: ❑New EtAddition ®Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ,two QE, I ECS /60P/7"i0NS "F Siiv 'L P 4101 RES,174Rie-, d- M1)41.`1 vim. %NI T eit.•.4 2 t2..,.lo, ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn XAlteration _Repair Type of Project: _New _Addn yAlteration _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 2- Kitchen Sink&Disposal Grease Trap Gas Range Ducting 1 Dishwasher Roof Drains Clothes Dryer Hookups Other: \ Clothes Washer Medical Gas _1 _Range Hood Water Heater Other: Exhaust Fan _ Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water INo.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 Cont ctors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 4 07 PERMIT#W (109.'001 Owner/Authori d Agent Signature Date (Revised 9/23/2016)