11312 1ST AVE SE 2019-05-22 - Laserfiche WebLink

PERMIT APPLICATION ign. BUILDING J IIIILCHANICAL/ PLUMBING /SIGN /*IIINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: /13/2- /ff 4-ti s•F evE1 6.TT 9rZos PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: MNe. /46014.446 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /r3IZ. jsr 4-ve s,a CITY vEkEr-r- STATE A)�' ZIP 9$,2 OE(' OWNER PHONE: ZOL- Y5 - 7776 OWNER EMAIL: CONTRACTOR NAME: S e_11 t or- 5.e f"v I C eS(� 0 V1 C `'10M (-S k C O t.(.1'i t CONTRACTOR ADDRESS: STREET ' Ito 2 f I r'po r t Rock C•I S ix f t E CITY 4- VQ.r e l( STATE ILA) A ZIP 9g-20 —/ CONTRACTOR PHONE: (--25 -2l'6 - Z22_2.- CONTRACTOR EMAIL: 1`1'1 h v SS•S CONTRACTOR LICENSE#(REQUIRED): S t d 56 21430 H. CITY OF EVERETT BUSINESS LICENSE#(REQUIREb O'5j 51'7 PRIMARY CONTACT: ❑OWNER I9 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: /,../z5-__ '3 ( a - I,,.,f,L Day\ CONTACT EMAIL: ✓ .\ r S S S C = a r BUILDING PERMIT APPLICATION 60 Existing Use of Building: Contract Price of Work:$ > P I + Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: kemoUE' F44-1.4> No C4„s) \ �/J�7rZic, NE,k) 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 Number 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 :urrent 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 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, Ind I comp with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 20/g PERM ,QA� C1 )wner/Author •- •gent Signature Date (Revised 5/20/2016)