2415 11TH ST 2019-07-31 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION 41* CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits ‘i(Blue a r"B1ack IniikzOnly pleslsn) -PROJECT..SITE INFORMATION' PROJECT SITE ADDRESS: 1.t1I,5 It."-‘ („ JI W PROPERTY TAX#: 15:105 POO 21 37(r) LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) t .., CONTACT"INFORMATION „ . OWNER NAME: for t)' ee,0,t r fct ,,.C.),.-,.4./? TENANT NAME(If Commercial): tri rt.e Cit—t), OWNER MAILING ADDRESS: STREET150CA tr� Ctree 7r S S't)i 55O ( ,p Z—((o GTY �/I/ �;�"t_, STATE � ZIP 00 OWNER PHONE: A44,NbA{C , 10'Z5-'2.4\91 OWNER EMAIL: f-tCCGitti d LRii i.(,....e f it-uw►tt rodeo CONTRACTOR NAME: 1141-14,1 31 k)5 3.41C, CONTRACTOR ADDRESS: STREET 14-2,77 1-sotNitiv, )J cnv '"'+p/v im STATE � ZIP cfr 5 CONTRACTOR PHONE: 4&22s3-32c ', CONTRACTOR EMAIL: 1VJk —cSai3QTbry-, -.0054 CO 141 CONTRACTOR LICENSE#(REQUIRED) ��Tff{x.90 pj c .ii CITY OF EVERETT BUSINESS UCENSE#(REQUIRED): ' j (31 PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Lt72,2 -'j 29,t, , Ai1C�►Z. Qi ry CONTACT EMAIL: ic4 e � �n t J e j BUILDING PERMIT APPLICATION 1A4 rq Existing Use of Building: Contract Price of Work: $ �i7 f w Proposed Use of Building: LHeat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: — ❑Commercial ❑Industrial • -'"fiType of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use _„ DESCRIPTION OF WORK: v t9 4C) Cb\a&ftlir CP‘AUQ)f-Z'\Ori, ASSOCIATED BUILDING PERMIT# if ap•icable : MCI ANICAL PERMIT"APPLICATION" PLUMBING PERMIT APPLICATION t` Type of Project: New Addn Alteration _Repair Type of Project: New Addn Lmo Alteration Repair i'' #.ar List of Fixtures #of List of Fixtures #of List of Fixtures List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handiin9 Units Heat Pump Toilet Backflow 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&.Disposal Grease Trap Gas Range Ducting Dishwasher - Roof Drains II Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: :$PRti+IKLBR.I SUPP.,.RESSi0i+[SYSTEM .".."-"ilChemical or Water No.of Heads 111.1 OM 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!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. jf;1 --- - City of Everett Official Use Only t1/1 I PERMIT I c $o 4-- 0 12- Owner/Authoriz gent Signature Date (Revised 9/23/2016)