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3007 17TH ST 2019-03-26
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3007 17TH ST 2019-03-26
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Last modified
3/26/2019 3:52:41 PM
Creation date
3/7/2019 1:16:58 PM
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Address Document
Street Name
17TH ST
Street Number
3007
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PERMIT APPLICATION■ <br /> BUILDING / MECHANICAL/PLUMBING /SIGN/SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> • Orffir 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION j <br /> PROJECT SITE ADDRESS: 3 waw nS ' EC Jt-L1.S-R PROPERTY TAX#: OOb®T OMOOLOO <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: SArc,3 4\4 i3iik.e-c-, TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ..14::)<Y1 VI-1'"' S ' i <br /> CITY G'J Q..'TC _ STATE \`B. ZIP C%�1 ""LI41® <br /> OWNER PHONE: I'M- q 113`1 tt 0 OWNER EMAIL: <br /> CONTRACTOR NAME: tilt(A � '-k>v ;� ( MIQ Us-MA CoiN)MOO ION i LLC) <br /> CONTRACTOR ADDRESS: STREET p© x1,0-* <l t <br /> CITY .."TsZ N, .Nt....S—t STATE i,.)q ZIP 953 a R5 <br /> CONTRACTOR PHONE: r S57-,1-15 CONTRACTOR EMAIL: Mtcw L P,-:,0 or_ 0 V <br /> CONTRACTOR LICENSE#(REQUIRED): M3PuCC,aSVI Cb <br /> CITY OF EVERETT BUSINESS LICENSE#(REQUI D): G ibq <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) O� L 6j1 <br /> CONTACT NAME: CONTACT PHONE: 5Q01-Ss`l•t.0,i- <br /> t\Icmac\ p\=n(3' CONTACT EMAIL: V\,CAk4.CeL, ‘ (1 °'f�iuul®,Cta,Q`�1 <br /> BUILDING PERMIT APPLICATION ) l" <br /> Existing Use of Building: Contract Price of Wor $ 4461.6/4 12411.°O <br /> Proposed Use of Building: Heat Source: ❑Gas 0 Electric DOther <br /> Building Type: , SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: DCommercial ❑Industrial <br /> Type of Project ONNew DAddition 0 Remodel URepair DTI. ❑Sign ❑Sprinkler ❑Demolition DChange of Use <br /> DESCRIPTION OF WORK: iikstiosm ,s.,N_tA4 b4F.rA ,4‘�� ,4L ‘,..45.c�� oil ,c` 64 �XS\'C,.�` <br /> Lp%-N LR S-vsps ya=p x i®` v-i." (35 S )% %0;&“to vire\A-,, �icf• (39—qJA )4 <br /> Vr'c (5 Ji: <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 41 ST: I INA- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New Addn _Alteration _Repair <br /> #of #of List of Fixtures List of Fixtures #of List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-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:I 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 /> 62. <br /> _...,„( � ��� `/ PERMI Oak'^ 01_1)2 <br /> Owner/Authorized Agent S' nature Date/ (Revised 9/23/2016) <br /> 6 <br />
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