3409 MCDOUGALL AVE GLACIER PROPERTIES 2019-02-20

PERMIT APPLICATI 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 (Blue'or Black Ink'Only Please)ss „ , _, PROD.ECT SITE INFORMATION PROJECT SITE ADDRESS: 3 4-0 j /)i e°D0'fj 4-L- A-(_G PROPERTY TAX#: 2`j'3 2 c/i cJ Z a)rv0 LEGAL for new construction: Short Plat/subdivision Are- -' /7�,r Lot No. ' (attach copy of long legal description) Oa._:~ t nre '..`} r aCONTACTwINIFORMATION i OWNER NAME: / n- v A-19 ,f7/2 e 1e es- -77dItENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 51-2-c.j 6 • /�J 7V7-746". c-' /� CITY 7 L© /- STATE l�� / ZIP 9 V 2, OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: C, A- FA=A./ ' f C'e p' v tzA,C)71 €'i1.7 / CONTRACTOR ADDRESS: STREET a Y o.5- e 0-n iai/7-9 CITY eV 1,5- & 7r STATE tri.. 4- ZIP ' - CONTRACTOR PHONE: ( -2_s-) 3 3 r ° S3"" ci CONTRACTOR EMAIL: 1 t •e. (.) ✓tj 4./-f,e1 f J;i Svc-/Z ., - CONTRACTOR LICENSE#(REQUIRED): 4'/9'F,�=/`/I C/0 Jc CITY OF EVERETT BUSINESS LICENSE,#(REQUI- D): It/at�Q b PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR %OTHER(Please Specify) A/2-e1/2'/`7,:r6 1, CONTACT NAME: / ✓'i fJ CONTACT PHONE: 9�S'- ) Z,}-Z Z/ 2 Ci' / 2- 47t CH/7 61--C76124; CONTACT EMAIL: //'t,,t'✓ (. ` AN 2 roy - ., N'; BUILDING PERMIT APPLICATION Existing Use of Building: 6 Ft----/c( / /9-„2.e *ad../e:::" Contract Price of Work:$ r e) c Proposed Use of Building: 0 -ilOG,./e-' Heat Source: 'cQ'Gas 0 Electric ❑Other -_ Building Type: ❑SFR-Detached ❑SFR-Attached 0 Duplex ❑Multi-Family-#of Units: ❑Commercial 0 Industrial Type of Project: ❑New ❑Addition 0 Remodel 'epair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 72_47-Ai L, ✓' 7i A,61 I L rem r it t p r4e `i sV[_. .J 1/.2)�I... ASSOCIATED BUILDING PERMIT#(if applicable): .i;MECHANICAL PERMIT APPLICATIOW , A,PLUMBING:PERMIT AP,PLIGATI"N t_.,,'. it 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 N Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced •' Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Was asin) 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 er: Exhaust Fan Sink(Service/Bar/Mop/etc.) Oth • Chemical or Water No. • 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 PERMIT#fl n e (11) Owner! uthorized Agent Signature r`' Date (Revised 9/23/2016) 4 �Y