6930 CARSON RD 2019-01-24 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES /$41:1‘f" 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 I;a+ kJf Ofil 60*** , . .iMRODE T SITE INFORMATION • . .. , a , .. PROJECT SITE ADDRESS: 6767�D -2S a a.) i PROPERTY TAX#: 003�33 OOOO7 000 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT'INF.ORMATI ON OWNER NAME: ,,vA/A o'"1-xiLim 2 7-71 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET / 9 )L j !LS d•�J CITY 6(1&y 71 STATE IAA- ZIP 9g2L 1 OWNER PHONE: 5-43 - -127 4 ,OWNER EMAIL: CONTRACTOR NAME: ,4(ryy/):thi 440 I. -v l-L CONTRACTOR ADDRESS: STREET Sc 0 21 T" 5 e /� C� CITY �A/D 1-4.c.11,--\)1/4_S (-1 STATE LA,4c ZIP / Y V1 (/7 CONTRACTOR PHONE: 4jc- 2s 3"3 627 to CONTRACTOR EMAIL: kS L.AeLmc,) A U64,4) CONTRACTOR LICENSE#(REQUIRED): A6-7/V/5100-1 L r2f(p 2-2- CITY OF EVERETT BUSINESS LICENSE#(REQ RED): PRIMARY CONTACT: 0 OWNER gkeONTRACTOR 0 OTHER(Please Specify) CON ACT NAME: CONTACT PHONE: ��¢¢ 12�-�1J!�✓✓ s4-Cr)Nl/� �Y,��_Z`' "� '-3(0-7 ZG7 CONTACT EMAIL: /4/s;4-A.r AG.V , „1/ ) /-/cr wtE-S.. +A-1 E UII: I G,PERMI"I"A.PU ATION. Existing Use of Building: 27.F/2- Contract Price of Work:$ / Proposed Use of Building: Heat Source: ❑Gas !Electric ❑Other Building Type: ❑SFR-Detached t SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial CI Industrial Type of Project: ONew DAddition EiRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: M g 6x tS.T rr-lr) 6r,4.a_ ,6 A g‘,. aca+ti. ►'�•t r- 6-5C-t.5 a--�- - Gi Az-4491C !n--7bey(' 4_4-1 /9r 2 ASSOCIATED BUILDING PERMIT#(if applicable): i I"V 12q 4-01.9-0/1. 0, (lam1,\AA. './ 41V ✓I\11 _ MECHANICAL'PERMIT.APPLICATION PLUMBING'=PERMIT*PPLICATION„ . 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 #of 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 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.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 PERMIT# Owner/Authorized Agent Signature Date (Revised 9/23/2016) e 13011,00{p)-V