2008 23RD ST 2019-03-08 - Laserfiche WebLink

PERMIT APPLICATIOI` '111 -IP°.446,0,--A BUILDING / MECHANICAL/ PLUMBING I SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES , 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: ',,Q 0 6 ,,, ,,3 d- S. PROPERTY TAX#: Q 0 439 t 4°1 ctib/ 0Z LEGAL for new construction: Short Plat/subdivision of No.t1'.j3(attach copy of long legal description) PF, 4 a 3,,...t.d, CONTACT INFORMATION OWNER NAME: t.�.� ,rN b%i_ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET leak 19kt" OR) ; CITY ��L,\i STATE 1.)...Y21/4.` 21/4. ‘ ZIP gp' ari OWNER PHONE: 142+5.`.2`1® "14 5"10 OWNER EMAIL: -1+� i h j4 1)I 1 CONTRACTOR NAME: t ''L 6Ziktere, CONTRACTOR ADDRESS: STREET ) CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: b t ''\!' L. r 1 I/ CONTRACTOR LICENSE#(REQUIRED): OF EVERETT BUSINESS LICENSE#(REQUIRED)\ PRIMARY CONTACT: XOWNER ACONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:«t\ 4 z5--R 31"40R 9 f`- ".-‘kik...- CONTACT EMAIL: 1 i V1.6\ " e bow BUILDING PERMIT APPLICATION ilrfExisting Use of Building: Contract Price of Work $ %r' `.-c2`t �p Proposed Use of Building: Heat Source: XGas ■ Building Type: )(SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project:Jew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demojtion ❑Change of Use DESCRIPTION OF WORK: N4 c' t SL Z SF 4- ,-.4i., 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 #°f List of Fixtures #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump 3 Toilet Backflow Preventer(Inside Bldg) ` Forced Air Systems Unit Heater K2 Bathtub Urinal Z Gas Piping Boiler 3 Lavatory(Wash Basin) Drinking Fountain ` Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove I Kitchen Sink&Disposal Grease Trap Gas Range Ducting 1 Dishwasher tie Roof Drains Clothes Dryer Hookups Other: i Clothes Washer Medical Gas tRange Hood 4Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM 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 1 1 / ? V - (/‘,1X(_:, lit - 1 17 PE IT#k^ k ,OO LA Owner/Auth ized Agent Sig a ure Date (Revised 9/23/2016)