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1014 ANGLE LN 2019-02-05
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1014 ANGLE LN 2019-02-05
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Last modified
2/5/2019 11:40:05 AM
Creation date
2/5/2019 11:40:04 AM
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Address Document
Street Name
ANGLE LN
Street Number
1014
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PERMIT APPLICA`f101�"° <br /> STTfilifr <br /> vitita ';= PERMIT <br /> -HJ1ECHANICAL/ PLUMBING /SIGN 1 INKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> (Blue or =-lack Irak Only Please) PROJECT SITE INFORM { <br /> TION <br /> PROJECT SITE ADDRESS: 1014 PtnsI[ Li h . PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision J Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Jan I GC 20-e TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1' O)c ZSR S P . Q �7 <br /> ^Gt CIT'YG�€r it4 4-E ' STATE W n ZIP Lett 3 <br /> OWNER PHONE: Lin- OS-2.5ZZ OWNER EMAIL: `Jan roc c29- e 1C.tOucti cor.- <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: N OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:�.•C.t�f�l• m _ CONTACT PHONE: (,,,�ZS- �- 2612.- <br /> CONTACT EMAIL: jar,rTX �f Q. cloud,Coq-. <br /> BUILDING PERMIT APPLICATION L <br /> cia <br /> Existing Use of Building: FeSrjdl.r�-kQ.1 Contract Price of Work:$ 4404C-' T ® I <br /> Proposed Use of Building: Heat Source: XGas ❑Electric ❑Other <br /> Building Type: (SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel KRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: rityikt.te las -Furnace ace W 64, VIQ.wY1Q t� lii,rtiovoz 'vo <br /> t.ASSOCIATED BUILDING PERMIT# if applicable): C ' " 1( a <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alteration )C 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 /> NC—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 /> 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/SUPPRESSION SYSTEM <br /> Chemical or Water I No.of Heads <br /> ACKNOWLEDGEMENT:/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 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PER IIT 1l 12-® ry <br /> (:) ,Ifui..4. ecRt5e..... <br /> caner/A thorizednt Signature Date (Revised 9/23/2016) <br />
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