7016 BEVERLY BLVD 2019-06-10 - Laserfiche WebLink

II'' PERMIT APPLICATIO II '1111144410 ".4 BUIL®INd�J MECHANICAL/ PLUMBING /SIGN �F�INKLER I DEMOLITION CITY OF EVERETT PERMIT SERVICES vidgY 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:-701(0 Ieveit,/ EIvS! ivere` - GA 9823 PROPERTY TAX#:00392,8 CO 10O'7O0 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:,/r0� 3 ,IJor l Eh�t C.- TENANT NAME(If Commercial): OWNER MAILING AD RESS: STREET `701(0 &ve.`(1 R Iv cry .E�/�e-I-f- ' J STATE (,a p1, ZIP 982,03 OWNER PHONE: ZO(o RcZ-737(0 OWNER EMAIL: 4-ro y eerie 0.41..c ' *CONTRACTOR NAME: /40 �y� pA ! CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building:/VA geontract Price of Work:$ 10,Oa© j4'tl 4/OG Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other Building Type: IgSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: tglNew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: J,6 Qudb AQA, deA,s...•4-c-L,a2 ,Qrel2. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New_ Addn _Alteration _Re Type of Project: _New _Addn Alteration Reps' #of List of Fixtures #of • of Fixtures #of List of Fixtures #of List fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump Toilet Backf reventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub ' al 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 P er Hookups Other: Clothes Wash Medical Gas Ran.- ood Water He r Other: E. aust Fan Sink rvice/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. City of Everett Official Use Only PERMIT`gaa � /ice L - . 1/2-2-//& 0, er/Auth. " -d Agent Signature Dat (Revised 9/23/2016) ( L)