5817 LOWELL RD 2019-06-04 - Laserfiche WebLink

BUILDING / MECHANICAL/ PLUMBING /SIGN /SPRINKLER/ DEMOLITION PERMIT APPLICATION 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) i+ 1 PROJECT SITE INFORMATION PROJECT SITE ADDRESS 69) /yLpj._e_t 'Rb POI' PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:�ATIZ ie^C ....1...[2.)lY TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET g? -7 Lc) Welt . :b cm, E V 1..s_e„ STATE tAl t'0 ZIP `l O 2.0 3 OWNER PHONE: 4252-3 8 q( 8 J OWNER EMAIL: i!-0 ti nCFr i cO Clik til 01 11141 1 CONTRACTOR NAME: TC re" ' , CONTRACTOR ADDRESS: STREET /7ff YQ (A) .. ✓R )4 frf MC, CITY l r}V 1A/:�L.A STATE_ ki•fzl '7'1 CONTRACTOR PHONE: las--2v�8 2--ag CONTRACTOR EMAIL: S"O1 rt6'(L oq 2g 40 .. .f74., CONTRACTOR LICENSE#(REQUIRED): /Gr Fr614'03g2� CITY OF EVERETT BUSINESS LICENSE#(REQ RED):4 6% 111 . PRIMARY CONTACT: ' OWNER 0 CONTRACTOR 0 OTHER(Please Specify) i '60 (im y 1.7"7/ CONTACT NAME: CONTACT PHONE: ti-2, - IZ5 2%q el 3.2J c)6,iYca- CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building: _Contract Price of Work:$ tg000 , 00 Proposed Use of Building: S11'e-d Heat Source: ❑Gas ❑Electric ❑Other Building Type: SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: lew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: '-1 -Flf)—--VO v l S10IL-)N`>l ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn _Alteration + Rep.'r Type of Project: _New Addn _Alteration _Repair #of List of Fixtures #of Lis-•f Fixtures #of List of Fixtures #°{ List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units -eat Pump Toilet :ackflow 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&Di ;isal Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer .ookups Other: Clothes .'her Medical Gas Range Hoc), Water; eater Other: Exhaust an Si Service/Bar/Mop/etc.) Other: SPR KLER/SUPPRESSION SYSTEM Chemical or Water I 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 f al,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 Offi 'al 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 c ply ith the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only q' W 0/<..,:;' [ DERMIT# - 1 646.r. n Owner/Authorized Agent SigLture Date (Revised 9/23/2016)