5705 EVERGREEN WAY BOSS CHICK 2019-02-05

PERMIT APPLICATION BUILDING I MECHANICAL I PLUMBING /SIGN /SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES .4 zeil- 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) j PROJECTO'. SITE INFORMATION� b------40 -, •`Ji � � PROJECT SITE ADDRESS: / `Q}�.�„\I sssU(IhPROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. Cb t (attach copy of long legal description) CONTACT INFORMATION JS 01 � OWNER NAME: ,i-)Q O DQ CA-AbIS TENANT NAME(If Commercial): (SA---1--hog-r_1/4SThl PO f p OWNER MAILING ADDRESS: STREET ()- eV e-eQ7 F--' 0<ki CITY ala STATE LOA- ZIP �1.- OWNER PHONE: -417`� 6 cc 2_ OWNER EMAIL: ate Alko .) ,D LE i • tq\,c L_. COM CONTRACTOR NAME: n —�e_^Adct.-- (,A-- CONTRACTOR ADDRESS: STREET l Q t 1 �J.�t Ef N 1' V -E my 1y�\J I Q STATE, ZIP 9 i 2 CONTRACTOR PHONE: p� L Qf 1:7--- -----1 L CONTRACTOR EMAIL: al ODL. c- - � G� (I N/1 .61 CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: `�"�1� - CONTACT PHONE: J� r p� I �I, i, CONTACT EMAIL: & DO` l;J - - . -© -1 -,,N L al BUILDING PERMIT APPLICATION s Existing Use of Building: t u�'P Contract Price of Work:$ , V' v , — Proposed Use of Building: 1 > Heat Source: ❑Gas Electric ❑Other Building Type: ❑SFR-Detached ❑SAttached ODuplex ❑Multi-Family-#of Units: Gommercial El Industrial Type of Project: ❑New ❑Addition model ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: ► K C- COT - X s ,S- 1 Kc)co S l,OV---S --7-D -EP( -. Op u cTc gb lIts ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn Alteration _Repair Type of Project: New _Addn d�(` Iteration 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 1 . 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 A................_ ' �� PERMIT —� ` Owner .uthori'.A.-• ignature Dat- (Revised 9/23/2016)