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5405 PARKVIEW LN 2019-04-29
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5405 PARKVIEW LN 2019-04-29
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4/29/2019 10:32:59 AM
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4/29/2019 10:32:58 AM
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Address Document
Street Name
PARKVIEW LN
Street Number
5405
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II PERMIT APPLICATION <br /> BUILDINt) MECHANICAL/ PLUMBING /SIGN/SPRINKLER/ DEMOLITION <br /> 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) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: Cj 1 0 S ('a.$'k.cvf et Liapk,t, PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Pws (7€. ' TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREETOMit,Q Q,g6.\/`e-� <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: a LO Pul 1W igil ( <br /> CONTRACTOR ADDRESS: STREET tic) <br /> �0/�+ )c>C C55� `3 L`L. �/�{) f� <br /> CITY LI -R- ��i I STATE �k- ZIP /..C]Com-/ <br /> CONTRACTOR PHONE: AS-3 8S'O r-/ CONTRACTOR EMAIL: <br /> Q <br /> CONTRACTOR LICENSE#(REQUIRED): 61.06AP if MS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 0010 <br /> PRIMARY CONTACT: 0 OWNER -CONTRACTOR 0 OTHER(Please Specify) <br /> jf <br /> CONTACT NAME: 1/ v); <br /> CONTACT PHONE: r.-05 6 -- l2 Q 6 — 90"o <br /> CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ o ,� — <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: DCommercial ❑Industrial <br /> Type of Project: ❑New DAddition DRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> \i-etr .-i,:y <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 X4„Pip <br /> #of List of Fixtures #of List of Fixtures #°f List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump 3Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater 7 Bathtub Urinal <br /> Gas Piping Boiler 3 '7 Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration J Shower Floor Drain <br /> Gas Fireplace Wood Stove / Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting 0-Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: I Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan0 ISink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM IN�J�O'�r�n�, <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 /> 0- (7 <br /> PERMIT# y <br /> 1 <br /> Owner/Authorized Agent'- s nature le / (Revised 9/23/2016) <br />
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