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2215 GRAND AVE 2019-06-03
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2215 GRAND AVE 2019-06-03
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Last modified
6/3/2019 3:34:20 PM
Creation date
6/3/2019 3:34:19 PM
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Address Document
Street Name
GRAND AVE
Street Number
2215
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PERMIT APPLICATION <br /> BUILDING/ MECHANICAL/ PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> "1111°'/ ---1 <br /> viii/Imo' - 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 /> (B,lue or:Black Ink Only Please) FO <br /> PROJECT SITE INRMATION <br /> `PROJECT SITE ADDRESS: .. l j t V yd A/� , l;Je4' 1f PROPERTY TAX#: Yar:?c/ t f3q 1103Y-0E1700 <br /> 2 <br /> LEGAL for new construction: Short Plat/subdivision 6LK ti$ 11.-OO Lot No.7 gg$ (attach copy of long legal description) <br /> t� CONTACT INFORMATION <br /> OWNER NAME: t�,/1,Y1$'!\' ( 1,e4 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET Z.ZI S 6' t,�c vju,Q_ r� <br /> / 1�CITY e � STATE W ZIP el 820 <br /> OWNER PHONE: C�2c)6 3 - /977 OWNER EMAIL: Ch113- 4n bftC-14te.c-'c UQ1et00.0-D� <br /> CONTRACTOR NAME: lc 11 <br /> CONTRACTOR ADDRESS: STREET 2.-24 t rt Avien ci_Q <br /> CITYFie/Hitt. STATE AA) ZIP `x'820/ <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: leOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: e _Contract Price of Work:$ 30°0 <br /> Proposed Use of Buil 'ng: �_yvt,d h t�7ot�I Heat Source: ❑Gas ❑Electric ❑Other OK-e— <br /> Building Type: FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units:—�` ❑Commercial ❑Industrial <br /> Type of Project: CI New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler Gdbemolition ❑Change of Use <br /> DESCRIPTION OF WORK: ge, el d p1 ,e /0 f ,x.2.01 .* b de,144.0 . <br /> aVF .a heady S pc'1 e i til 1�f's-Lod-ice v-E_VItt we v. efrtd kS <br /> $4,a `7taf ' it rYt v i�ecvd j77i , Wta er n �t/4- <br /> ASSOCIATED <br /> t v� <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ars 90 i/ Wi lI b ° 1 t/ i70N-PO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal _ Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer _ Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER'/SUPPRESSION SYSTEM <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 /> PERM <br /> Owner/Authorized Agent Signature Date (Revised 9/2 /2016) <br />
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