5702 S 2ND AVE 2019-05-23 - Laserfiche WebLink

PERMIT APPLICATIA 0C: BUILDING/ MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION � CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 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: 57002 S (91."14-LE- PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: n t= (A/7=-F5 — TENANT NAME(If Commercial): OWNER MAILING ADDRESS: , STREET 576,2 5a,cm, -j(--(mo Fa )c,3 4 V STATE � ZIP /a) OWNER PHONE: 17e;75-.00 -7 4"54. OWNER EMAIL: C,41-1rLEE •: s-.-7 , hemp . ca-I CONTRACTOR NAME: L'''3 . f CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: XI OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: f MEI 4)1k/E7L Fx/.,_ Contract Price of Work:$ ( DO.. Proposed Use of Building: rye-- Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition EIRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: (.4.2.reeejvt egd/94 uE ltD NA. 64-5 CitgED S.DgAgg 0icF c-de Pass I-Lc/-- 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 ' No.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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT 9s) IliDi5 ---.) . ,, Ow.- .uthori -d Agent Signature Date .: (Revise 9/23/216)