1014 ANGLE LN 2019-01-17 - Laserfiche WebLink

PERMIT APPLICATIO Roa4 opv ,,,A10/7,--A BUILDIIl I MECHANICAL/ PLUMBING /SIGN RINKKLER/ DEMOLITION iiiiiwi _ 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 Irak Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: t Q 1 L f 1.t" ,�P PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision- Lot No. (attach copy of long legal description) 4 CONTACT INFORMATION ... ...-.... OWNER NAME: _1Ct,4'1.([e_, 'Rae TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1 0. BOX ZSi c cry Y//u.e •cT► STATE tU R ZIP _9 9 Z t e2-2 3 OWNER PHONE: 42c' 308 ' ► OWNER EMAIL: �Ja..(r1.ro e c�^ € I ctou.GI.corn CONTRACTOR NAME: Po lar Bear fle_rti/9 SOlu-f1Oh 5 CONTRACTOR ADDRESS: STREET 1-11.411., �S$L' (R. Rd CITY (fl u_k.(1 4.c,0 STATE LA-)A ZIP q s 2 3-s CONTRACTOR PHONE: 42S- MO-5(06 CONTRACTOR EMAIL: polarbea..rntau. con-, CONTRACTOR LICENSE#(REQUIRED): poLARt36,ell q?.. CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 13 W0 PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME:'Roc PHONE: 42,s- 308 -28 21 .3antt.e `Roc CONTACT EMAIL: sJany-oe cl q e 1c ol1,d. Cotte BUILDING PERMIT APPLICATION Existing Use of Building: r esI(t,tnt( , siri9k fuYri:(,4.1 Z 3 c Contract Price of Work:$ o Proposed Use ofaBuilding: Stuw+G Heat Source: Sas ❑Electric ❑Other Building Type: 'SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family #of Units: ❑Commercial 0 Industrial Type of Project: ❑New ❑Addition ❑Remodel Repair DTI. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: KC hntlJ ak artvYt'AN't , c corm 4 t.. r x t re-paw 4 dc�ma9 C , re tact W t� ase,at+ shui9iL rcra� 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 #of List of Fixtures #of List of Fixtures #of List of Fixtures #°f List of Fixtures Fixtures . Fixtures Fixtures Fixtures A/C—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 Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: • Clothes Washer Medical Gas Range 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 2 PERMIT1-#6 \1 \2,1)9i/ \ I \2 - D?71 Owner uthorized Agent Signature ' (3-ate (Revised 9/23/2016)