9931 18TH AVE W 2019-06-05 - Laserfiche WebLink

ki:46-77- PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN I SPRINKLER/ DEMOLITION 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 (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: q q 6 i loolik Ave, Ut/f,q-- see, 3.3 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. f (attach copy of long legal description) 6j(,`� CONTACT INFORMATION OWNER NAME: 1\, �-h.e i' --N 1 �t a ne C, U M TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET �! j'3 I t, h- 44, ,,,./e.:)1--- 5 fC- 3 3 �y �}y� L�crrY / - NJ STATE t, zip d 7 2-Z f / OWNER PHONE: r Q2 !0 -67 �t9C.(/ OWNER EMAIL: et`-A f tt.� — L.Jt)Il1�/ /1 �e yuMoD. Cwn CONTRACTOR NAME: . e,,,I nc 1 e ,c e)(d. S CONTRACTOR ADDRESS: STREET �( �/107 3• Lf 7 f � / c/_ CITY of ti I en , +j t STATE LAI it ZIP (i-A 7 CONTRACTOR PHONE: 1(2-5---1119:3 �'t.. ,53 CONTRACTOR EMAIL: L-yolive-Vt.-4rk- 4�r c 1,171 CONTRACTOR LICENSE#(REQUIRED):£tL, f3 S 7E'O CITY OF EVERETT BUSINECENSE#(REQUIRED): /p2?V PRIMARY CONTACT: Q OWNER rI4CONTRACTOR 0 OTHER(Please Specify) Vii" CON_ TACT NAME: CONTACT PHONE: L( c.-L.1 q 3- 5; '573 \m_iA,e-, 670114/10 ) CONTACT EMAIL: (,.yonr,i- t/d, /g j 0(107. BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ 0 1i,32 l Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: r` 1_,, e_.--For k t r-) d l vt<s - iatt /V e,W i-ka t0v 12 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: 1XNew Addn Alteration Repair Type of Project: _New Addn _Alteration Repair #of #of Fixtures List of Fixtures List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units 1 Heat Pump Toilet Backflow Preventer(Inside Bldg) I 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/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 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. CYCity of Everett Official Use Only 7 ' ( /� %(/ —_ 1/ r PER INET R ' 10 +U �' 0 V k Il \ ner/Authorized Agent Signature . Da (Revised 9/23!2016)nR /l- i J/