1621 HOYT AVE 2019-03-27 - Laserfiche WebLink

Aow PERMIT APPL9CATI®N! BUILDING / MECHANICAL/PLUMBING I SIGN /SPRINKLER/DEMOLITION 4111/141Y. CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everefteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1(OA \ \`d - Ave . PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) n^ CONTACT INFORMATION OWNER NAME: {'UiCtrIZ- GUti✓�'f/4 5 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET \/Lp21 L�y�- p-,Ae CIN t�/rV Q re l�"I STATE)) (Ai4. ZIP q g 2-(^) 1 OWNER PHONE: C1Z S (33" l 2 2 0 OWNER EMAIL: k 2 Crow!C� app �/�al-044,V. co 121 CONTRACTOR NAME A-v4 f DVI SFes 1744.<`dVi CONTRACTOR ADDRESS: STREET 20 2:7 Broad(,./a-y CITY STATE wA , ZIP 9 g�O f CONTRACTOR PHONE:C3(o) (p S/ ?"(oz) CONTRACTOR EMAIL: u t 3 3 CONTRACTOR LICENSE#(REQUIRED): /�Y1(j i'(l R(0! L-T- CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): dS 4 PRIMARY CONTACT: lig OWNER ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: 61.en n ketbbb e/,�1 yy,�;J, 0,01,4ICONTACT PHONE: CONTACT EMAIL: • BUILDING INFORMATION Existing Use of Building: Contract Price of Work:$ (act 9 Proposed Use of Building: Heat Source: RiGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU OMulti-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: r'e Aovc � C��t� W c)tl� tvt52I.+ c e\ f ov c' c 10 4 - d42 8 c„S t�� f(n2 Pepe plcice. The tins l�cvtr new 545 /P1.5e.r¢ J ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures NC—Air Handling Units I F/ Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer • Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: IChemical or Water J 1No.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 l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMT# 2 Owner/Authorized Agent Signature Date Revised 10/1 9 9 ( /2018)