8810 5TH AVE W 2019-05-23 - Laserfiche WebLink

Apr 24 2018 01:45PM Washington Wat eaters 8663757454 pag PERMIT APPLICATION grr BUILDING/MECHANICAL/PLUMBING 1 SIGN I SPRINKLER f 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( wuwv.everettwa.gavlpermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:(r} 6a A-i'-e,&) PROPERTY TAX#:/3b15 7,49--aj LEGAL for new co istruction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 'VC)IF I 14rid ire.,CU TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET s?0 I-�! J k) J�4 a�yt 7�/J - CITY _ STATE /J Zip 6V L1J'f OWNER PHONE 2.66--232- Sc --56-.) OWNER EMAIL: CONTRACTOR NAME: Wit-51 1 A-16 77,0-1 j,A)ii-TEI ,- -FiCiei CONTRACTOR DDRESS: STREET (115 L. We, ,4-r. -- PO iiv 026? �jJ (� CITY ,f-t1 r STATE Q 119 ZIP t O fl S0 CONTRACTOR HONE: '/ZJ-frg3-- Lig71 CONTRACTOR EMAIL: tAjk-t(j 'V -G 6 ,4611-4 (9/12 CONTRACTOR t!CENSE#(REQUIRED): Wi4-54Xgg1Op CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 05 g9 Ail PRIMARY CONTKCT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME. CONTACT PHONE: Ch... .-F -- -ca 7/ 1 06-61-6 1S CONTACT EMAIL: �iv's}-til -th,J`}ctt E olit,,(no l BUILDING PERMIT APPLICATION c� Existing Use of B gilding: n 7-/ Contract Price of Work:$ VWU - Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached DDuplex ❑Mufti-Family-#of Units: ^ ❑Commercial ❑lndustri= Type of Project ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign Sprinkler ❑Demolition ❑Change of Use .r¢,i i • DESCRIPTION OF WORK: 041/1 Pt-t- (11 hliate. / 671/10 hi a./.. tik' /U C/1/7 ASSOCIATED BUILDING PERMIT#(if applicable): _ MECHANICAL PERMIT APPLICATION ) I ! PLUMBING PERMIT APPLICATION Type of Project: New Addn _Alteration _Repair , Type of Project: , New _Addn Alteration Repair #of tr.Y of Fixtures #of Fixtures Fixtures List of Fixtures Fixtur s List of Fixtures Fixtur s List of Fixtures A/C-Pit Handling Units Heat Pump Toilet -Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater _Bathtub Urinal Gas Pilling -Boiler Lavatory(Wash Basin) Drinking Fountain ` Water Heater Refrigeration Snower Floor Drain Gas Fit,place Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher _ Roof Drains Clothes/Dryer Hook_los Other: C'othes Washer Medical Gas Range Mood Water Heater Other: Exhaus�Fan Sink(ServicelBar1Mop/etc.) Other: • SPRINKLER/SUPPRESSION SYSTEM I 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 current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must 7rst be authorized in writing from the Suliding 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 1 comply with the State Contractors Law 1 T ROW and Z96.200A WAC. I , CityofEverett Official Ilse Only 4 J lr (�J7 jg PERMIT,f(�n l oL4 o ,� 0 er/Authorized Agent Signature '�(- f '//j/Date (Reviser!5220/20'16)