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1216 HOYT AVE 2019-03-27
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1216 HOYT AVE 2019-03-27
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3/27/2019 1:44:18 PM
Creation date
3/27/2019 1:44:18 PM
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Address Document
Street Name
HOYT AVE
Street Number
1216
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"11111PERMIT APPLICATION <br /> BUILDING/MECHANICAL/ PLUMBING /SIGN/SPRINKLER/ DEMOLITION <br /> M CITY OF EVERETT PERMIT SERVICES <br /> 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) /fPROJECT SITE INFORMATIONPROJECT SITE ADDRESS: (r )" 1.1t es u/�/r E/)Z�i11CT11 (/ <br /> PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: AAMet, AA M%�/l//jl/j ,/ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET [ 7,..1(0 /A yr <br /> CITY (../v STATE .. ZIP 9/2 / <br /> OWNER PHONE: 7 . /L l I OWNER EMAIL: h C�G4/yn p y p 6mok ., ea-r^---- <br /> CONTRACTOR NAME: l/ e( 2,6 ,iu S (Co'D 0 A/9 <br /> CONTRACTOR ADDRESS: STREET /2,5-7 r ' 2 - f2_,,. /�/ <br /> CITY / "�. <br /> 'W?ri�. .� •- Ki•>-« STATE 07A- ZIP g0 1.7. <br /> CONTRACTOR PHONE: 54 7.9/,/ .r CONTRACTOR EMAIL: t//(8/2jO/e'i// , 0-014 �/ <br /> CONTRACTOR LICENSE#(REQUIRED): (JJcao/'/? ' if ,� / r CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): V...7,"/ <br /> ,T <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR /❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ / -I'' ° <br /> Proposed Use of Building: Heat Source: ❑Gas DElectric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I: ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> At PL)f Ex/c17/1q c ie. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #°f List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—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 /> '.� (7 PERMIT t ' r, 62' <br /> Owner/A t .. •. -:- Signature Date (Revised 9/23/2016) <br />
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