605 LAUREL DR 2019-02-11 - Laserfiche WebLink

PERMIT APPLICATIC ifitIP— BUILDING / MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 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 PROJECT SITE ADDRESS: tpoS(inatrei Q r. 61kererck PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) z i t ;.,''-_. r �'' �+ '3 E 5 t i \g\`:% 4,...E 3 t1`N ri .,,,,��;e ? # T� \- '� 'EI Ain ... ... �'� OWNER NAME:.? A ((Lauct,Ltin r4asp( .e.) TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET IDYZ.Z., txy L L Si-C,... g"7 CITY Er-lerVilk STATE - ZIP CW2C1-4 OWNER PHONE (OWNER EMAIL 4 q),,, -,p (gyp CONTRACTOR NAME: 00,vieAr" CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): 1\3\l'''''''''' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED)M 4 ' PRIMARY CONTACT: IX OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: ( � CONTACT PHONE: ,Z (O.4 .67 2.4 &7 ��y-1 {^'C®r W� CONTACT EMAIL: Existing Use of Building: 5F- Contract Price of Work:$ WM. Proposed Use of Building: b .QHeat Source: ❑Gas ❑Electric Other ba k t Building Type: ❑SFR-Detached SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: A( 1ne c�a G.S C,i3n. na J&tJ25 . ASSOCIATED BUILDING PERMIT#(if applicable): aaee�� 6 <. i� ,,,jQ, f' A!I 0 ,x'p° .,..lt\.. $�:...., ;p- sio E, :14. �E.tic y,�,� r„,.ink, iE „ Type of Project: _New Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures A/C—Air Handlin• Units —Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air S stems —Unit Heater Bathtub Urinal — Gas Pis in. —Boiler Lavatory(Wash Basin) Drinking Fountain NM Water Heater —Refri•eration Shower Floor Drain Gas Fire lace —Wood Stove Kitchen Sink&Disposal Grease Trap Gas Ranee —Ductin• Dishwasher Roof Drains Clothes Dryer Hookups —Other: Clothes Washer Medical Gas Ranee Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: _Chemical or Water 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 i dor,.—.. L j 4t24[(6 P EMI # 02— —032 ......___ Owner/Authorized Agent Sign ure ate (Revised 9/23/2016) ~N V_3)