3030 BROADWAY 2019-01-17 - Laserfiche WebLink

OPPPERMIT APPLICAT— BUILD■ i MECHANICAL/ PLUMBING /SitfN I SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES Niiiwo 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 o r Black Ink c n**eaan) PROJECT SITE INFORMATIOtI �> .. . � ,per , _ a>� 1,,P4'3,/1 b`""' - ••PROJECT SITE ADDRESS: F7 t PROPERTY TAX#: �<107/ 1 0 I LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) 600 CONTACT INFO RMATIO , , OWNER NAME: 1�, , 7L ..--./4014 P TENANT NAME Of Commercial): V / C .F.WNER MAILING ADDRESS: STREET 630 3 s a, (�v l // CITY e/ � STATE t ZIP q9 d 5 d OWNER PHONE: "LOG 307— '6010 OWNER EMAIL: kil 6 Seek 1Fet' v 1,a VWNA&[ / C"."---- CONTRACTOR NAME: „ Q CONTRACTOR ADDRESS: STREET <ye../. CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: D OWNER D CONTRACTOR THER(Please Specify) CONTACT NAME: �"��& B� ` 11 CONTACT PHONE: ,?,.5 3 („i�� 7 T 'r`. , c ss r � .o c "3' CONTACT EMAIL: �4✓lee_ A e /kJ a -c-L I— G�-�-� r` ., -,. ' ' �. BU.ILDiNiG;PERMIT APPLICATION Existing Use of Building: 40/—I Contract Price of Work:$ :/e,2,67 ” Proposed Use of Building: i1 Heat Source: OGas Dlactric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: a4rnmercial ❑Industrial Type of Project: [New ❑Addition 2emodel C]Repair DT.I. ❑Sign ❑Sprinkler ❑Demolition OChange of Use DESCRIPTION OF WORK: 1),-)e.,,,,,--- re 04 e- I e` (�. b��^� ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT,APPLICATION "��I" PLUMBING PERMIT APPLICATI4ON Type of Project: New _ Addn _Alteration _Repair Type of Project: New Addn ,QAlteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures •Fixtur Fixtures A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater athtub Urinal Gas Piping Boiler r.. Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration , hower Floor Drain Gas Fireplace Wood Stove IGtchen 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 1 SUPPSION SYSTEM'° 'Number 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.l am the owner,or I am authorized by the owner of this properly 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 PERMIT# � >,,,� Owner/ thorized Agent Sign re ate (Revised 9/23/2016)