10606 10TH DR SE 2019-06-05 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/ PLUMBING/SIGN /SPRINKLER/DEMOLITION Ahor 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) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 10606 10th dr se PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Eric White TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 10606 10th dr se crry EVERETT STATE wa ZIP 98208 OWNER PHONE: 206 200 0447 OWNER EMAIL: b.eric.white@gmail.com CONTRACTOR NAME: Axiom HVAC CONTRACTOR ADDRESS: STREET 2232 BROADWAY cin EVERETT STATE wa ZIP 98201 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED):AXIOM1892RM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 054279 PRIMARY CONTACT: 0 OWNER L CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425 879 5351 daron smith CONTACT EMAIL: daron@axiomnw.com BUILDING PERMIT APPLICATION Existing Use of Building: sfr Contract Price of Work:$ 800 Proposed Use of Building: sfr Heat Source: ❑Gas ( Electric ❑Other Building Type: WSFR-Detached ❑SFR-Attached El Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: El New ❑Addition ❑Remodel ❑Repair OSign ❑Sprinkler El Demolition OChange of Use DESCRIPTION OF WORK: add gas line for firplace and stove 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 A/C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal 2 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 1 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 X0417 #6 P #` k d \ 2_ Owner/Autho' Agent Signature Dat (Revised 9/23/2016)