8528 10TH AVE SE 2019-06-05 - Laserfiche WebLink

PERMIT APPLICATION OAP' 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 1 www.everettwa.gov/permits (Blue Black Ink.Only Please ., A_ PROJEC TSITE INFORMATIIOIy . . . :.. _.. PROJECT SITE ADDRESS: 8 ) 10)14 � 3€_ PROPERTY TAX#:601-110gS-OCY,D05g00 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT'INFORMATION . OWNER NAME: 2-0.1(( fi i L ar a L.J'r I )p n TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET (3Sj 9,8 (044" A-v-e_ 5e...- CITY STATE li/'"'C ZIP 9E3 B OWNER PHONE: (E/25) 9-85 - cis-51 OWNER EMAIL: WI)DDy\©pg-ComCom co-,A.h-(, CONTRACTOR NAME: '111 V( (5 1-keech yx q Inc CONTRACTOR ADDRESS: sTReEr J 6qa'5 9 t b-1" 6i- 5Lt.)/ S 04 C CITY h Jl t�z'k .4 STATE �� ZIP 320 CONTRACTOR PHONE: (ii c) a 5 IC-5 CONTRACTOR EMAIL: Int L'L aid c•e @ ,,ijsiA-ectsts tjr CONTRACTOR LICENSE#(REQUIRED): Kt N(..S)4I MA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): r) ?Sl i PRIMARY CONTACT: I$rOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: (( CONTACT PHONE: 0_05) 9,3 "[2,— t lo'(( W i bO A CONTACT EMAIL: lAir 1 Soy\ ) - 0 Corn.C C34-.YU.t-- . . i. BUILDING PERMIT AIPP ,KATION .., Existing Use of Building: Contract Price of Work:$ 12-, aa Proposed Use of Building: Heat Source: Mas GS-Electric ❑Other Building Type: ❑SFR-Detached ft-SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial Type of Project: RiNew ❑Addition ❑Remodel CI Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use D CRIPTION OF WORK: e (cam ku rsArack. l<c�. < L c . i v►5k t, a_ S ,n: \v/4.3 o),vc-Ftess 1 . ASv 9.0A t ocw `� SOCIATED B LDING PERMIT#(if applicable): .MECHANICAL PERMIT A001400104.7.'.Y'''''' .. ' .; PLRtiIBfNti,PE0.MrT APP0C01,oN,- ; 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 i Heat Pump Toilet Backflow Preventer(Inside Bldg) 4 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 I SuJPP IO i STEM ' F IChemical or Water I INo.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 Buildi g Official before,-,ing au,•-zed •der any ci mstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made, an .mply with ft), to . to . .w 18.27 T W.nd 29 00A WAC. if �f /� City of Everett Official Use Only 4 l ( PERMIT tn l LJ 61 �6,2)LA Owner/Authorized A.• t ign• Date (Revised 9/23/2016)