2120 E GRAND AVE 2019-03-22 - Laserfiche WebLink

II''II � PERMIT APPLICAT��I OfiIIP"—' BUILDtfG/MECHANICAL/PLUMBING/SIMM) SPRINKLER I DEMOLITION CITY OF EVERETT PERMIT SERVICES 1 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps©everettwa.gov t www.everettwa.govipermits (Blue or,Black ink Only Please). PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 212.0 V-. UeCtCt 10 PVE. PROPERTY TAX#: 6037 7 yet 570 2 2 on LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER.NAME: T fv-e k...olz t•3 t c.r\OLS TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET F O. i>oX 1\ bt cnv L Pik t 'S-rtve"S STATE W PC ZIP q $Z S g OWNER PHONE: (f0 C) `1'1'3 - -1-LS 1 OWNER EMAIL: Ta. Tv ?NI v,- C. t",00--- 4-d CONTRACTOR NAME: M%kc E. Dek- t N f .'1'''�N1C C_O N-02 Or c_-yo 2. S L L.f— CONTRACTOR ADDRESS: STREET 2.02(0.0 '7 2. Cr k/>` N l ) yy G C1TY S-r Pc NIL../oo C) STATE *•-) ' \ ZIP O 2.E 2 CONTRACTOR PHONE: M0ej,,$3L(L-CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): (003¶ rt61 1 t\ nb .Drd CITY OF EVERETT BUSINESS LICENSE#(REQUIRD):IC& PRIMARY CONTACT: 0 OWNER Z CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (`\-is) 3 4-y 2.4 2 S N% 11st DE pt NE:", CONTACT EMAIL: . D t Ks'" Or`I t ( > (. ,M t L .v M • BUILDING PERMIT APPLICATION Existing Use of Building: S @2„ -1 Contract Price of Work: ZOO Proposed Use of Building: '43 (2..... Heat Source: ❑Gas ' Elect c L ❑ ther Building Type: SFR Detached ❑SFR-Attached 9Duplex ❑Multi-Family#of Units: ❑Co mercial ❑Industrial Type of Project ❑New ❑Addition ❑Remodel ❑Repair 7z1T.I. ❑Sign ❑Sprinkler emoliti ❑Change of Use DESCRIPTION OF WORK: t -t1Getd> . VII"-1- die-_coar4't"i.. •-rtde"/ i 10ts XlS�itrG' c✓4'-'- ASSOCIATED BUILDING PERMIT#(if applicable): /< C. (/f77L/R6441. 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 NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater r' Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal 4 ` 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 I SUPPRESSION SYSTEM !Chemical or Water f No.of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained hereint 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 1 am authorized by the owner of this property to perform the work for which application is made, and!comply with the State Contractors Law 18.27 RCWand 296 200A WAC. City of Everett Official Use Only __..._ PER IT te..40 c4 _0 2._.(6) Owner/Aufh4rized ent Signature Date (Revised`9/23/216)