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4727 EVERGREEN WAY GEORGE ORTHODONTICS 2021-02-18
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4727 EVERGREEN WAY GEORGE ORTHODONTICS 2021-02-18
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Last modified
2/18/2021 10:45:07 AM
Creation date
1/29/2019 10:31:07 AM
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Address Document
Street Name
EVERGREEN WAY
Street Number
4727
Tenant Name
GEORGE ORTHODONTICS
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r <br /> o <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> /111.1*04J---:A CITY OF EVERETT PERMIT SERVICES <br /> ' 7 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) ,PROJECT SITE INFORMATION , <br /> PROJECT SITE ADDRESS: L 727 £V E jREE7J WAN( PROPERTY TAX#: 001—10 7501'GQ8VO <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: tA/....,G r ,71 Es LLC,, TENANT NAME(If Commercial): pg O'DCal�l'T7C�cLIj'vq% <br /> OWNER MAILING ADDRESS: STREET 17(2Q PATEN Oa 1) <br /> CfY SK)O b-FOhAt.ISI}', STATE WA", ZIP cla 230 <br /> 0 <br /> OWNER PHONE: 62 ) 2.5e- I I2.1 OWNER EMAIL: 'IVAE ? k) cYVV ,ehQL..COM <br /> CONTRACTOR NAME: L.ObESTRg.., )+VA <br /> CONTRACTOR ADDRESS: STREET `Z 11131 72 ' AvE• V1i'< <br /> CITY EbMOj. ►A✓ <br /> j STATE A ZIP ci5c) <br /> CONTRACTOR PHONE: 0 ) 670— 19{y8 CONTRACTOR EMAIL: JQt L sZtIE t1Tg,}-V .(i i <br /> CONTRACTOR LICENSE#(REQUIRED): Lobes t41SL-{S,PD CITY OF EVERETT BUSINESS LICENSE#(REQUIR • : 05C383 <br /> PRIMARY CONTACT: 0 OWNER 1,.4-CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: { !`� CONTACT PHONE: (L.t ) 6t70-196a <br /> A <br /> FNOD C f �.ST)AN CONTACT EMAIL: g,ob a 'L.�?. v i+VACS r Coll <br /> BUILDING PERMIT APPLICATION, <br /> Existing Use of Building: Contract Price of •rk:$ 159 0564 -# TIV <br /> Proposed Use of Building: Heat Source: U Gas ❑Electric 00th <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of its: $Co ercial El Industrial <br /> Type of Project: :New DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign OSprr er ❑Demo" ❑Change of Use <br /> DESCRIPTION OF WORK: ....r44, !�� EX,��' G � L1„,,E ......r.„) �v <br /> '- R p, t T <br /> NJ&W GA-3 R F-PLA-ce. (57/ABO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): PL k, "D 9 — vv 5' ) <br /> MECHANICAL PERMIT APPLICATION MBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> I Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Chemical or Water I No.of Heads tal( 9- 15q.D <br /> 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 <br /> 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 <br /> 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, <br /> and I co r.ly with the St.to Contractors Law 18.27 RCW and 296.200A WAC. <br /> f � City of Everett Official Use Only <br /> f , (LoDS5rAF, /5/I7 PEge)'O ner/Authon-: A ent a� Date (Revised <br /> 9 Sig 9/23/2016) <br />
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