2618 MAPLE ST 2019-02-11 - Laserfiche WebLink

PERMIT APPLICATIO "IIP BUILDI ECHANICAL/ PLUMBING /SIGN 1 HfRINKLER/ 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 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION iveretlv PROJECT SITE ADDRESS: I r ! )1 . 4.0101 PROPERTY TAX#: X015 OOL/3 I LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: p-4 //amen TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 9.6 V t pk L)� �y _ cm, Fv�"e _ / STATE L," ZIP �V i OWNER PHONE: .6_737-fs�5 OWNER EMAIL:,S11 ,tx,/ ( _ 1/7(b G-hett:1 Cali CONTRACTOR NAME: O NULL CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: it OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION 1 /� Existing Use of Building: Contract Price of Work:$ ;6 0 Proposed Use of Building: Heat Source: IgGas ❑Electric ❑Other Building Type: LiSFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New EAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 1A.,/' (rt I,`fie, 0,900 3 u F6,010'(-4 i go) 000 Bra fin/L/ /5 1-.4)e( firfrfer ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION 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) I Forced Air Systems Unit Heater Bathtub Urinal a Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain I 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/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 Conti ctors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only //5/a0/8 PERMIT#9/23/2016) M ( D 0! .. d zg /caner/Au orized Agent Signature Date (Revised