5512 1ST AVE SE 2019-05-22 - Laserfiche WebLink

IIIII PERMIT,111P,AV--_ .--A WV APPLICATIO• BUILDING/MECHANICAL/PLUMBING /SIGN I SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please)) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: CJI IS` Mile-SE j E/.(� , INA°8zO3 PROPERTY TAX#: QQ?c4,33f2OOO 6300 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: e --Ho yeti TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET tJZ- 1S-L Ave E /� .,,�z j CITY 51,Qjre-t'f STATE k ZIP `l R L(�1.7 OWNER PHONE: 4-'24--6f�''--g f , g 70WNER EMAIL: I-� CONTRACTOR NAME: 1& Imtern tirkg0., LIYbIIo 73Y.os l e#1- CONTRACTOR ADDRESS: STREET /2 f# + ey'f7rept )R Muw^/r/fe - 9g29 CITY A�f,/�r f I'�'�i STATE WA' ZIP g8.2-1X' CONTRACTOR PHONE: lf2- 17 12-0 CONTRACTOR EMAIL: Iyl Q CONTRACTOR LICENSE#(REQUIRED): URIi=ZR 9 j�g CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): • U PRIMARY CONTACT: 'OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAM�}E: CONTACT PHONE: £f2 j f�__g f/g eHT HO YEH CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ Proposed Use ofBuuii ding: Heat Source: El Gas DElectric ❑Other Building Type: ltdSFR-Detached ❑SFR-Attached El Duplex El Multi-Family-4 of Units: ❑Commercial 0 Industrial Type of Project: ❑New DAddition DRemodel DRepair ❑T.I. DSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: C rete Tel/4r In5t4 &t t 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 #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 Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal 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/SUPPRESSION SYSTEM Chemical or Water I No.of Heads • ACKNOWLEDGEMENT.'!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. � W'r/ Q Cityof Everetttt Official UseeOOnly C�- G, O 27 J� PERMIT# 1 �D - —. 0.3?' Owner/Authorized Agent Signature Date (Revised 9/23/2016)