7523 BROADWAY 2019-06-10 - Laserfiche WebLink

PERMIT APPLICATiO BUILDiNCHANtCAL I PLUMBING I SIG RiNKLER I DEMOLITION CITY OF EVERETT PERMIT SERVI Imo' y- 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 75w\etPROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision 55 12, -00 _Lot No. S.- (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 044;r I rises L.C. TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET �/� E 4 Si- g xi,theC De:VV. CITY tins, w o od STATE IW h zip WO ri OWNER PHONE: Lac-7 L3- Ii!Y OWNER EMAIL: pm `t{Hs 1•G©�,r► CONTRACTOR NAME: 14def ,h Y` is-44 L C CONTRACTOR ADDRESS: STREET ft'ti" _ E.4 s÷ ,t e. .. cry ° 0 o STATE a J,4[ ZIP #49 10 "7 CONTRACTOR PHONE: ( j5'. 7qf . 17 If CONTRACTOR EMAIL: kidieir' _,trphs,a e oyIn CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT:0OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: Kai_ t5 CONTACT PHONE: Lit 3 tit L 3 7 CONTACT EMAiL: )F ft= 4.14 1.4,1-4",54s 4 ts44 t ��ow BUILDING PERMIT APPLICATION Existing Use of Building: t etc 4.t !e' Contract Price of Work:$ t= Z i G / 1 � Proposed Use of Building: 5 F R Heat Source: , Gas ❑Electric ❑Other `1 Building Type: I 'SFR-Detached ❑SFR-Attached ❑Duplex 0Multi-Family4 of Units: ❑Commercial ❑Industrial Type of Project: IgNew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler El Demolition ❑Change of Use DESCRIPTION OF WORK: N SPR on Lo 5 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 #of List of Fixtures List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units 0 Heat Pump 7 Toilet (} Backflow Preventer(Inside Bldg) Forced Air Systems f Unit Heater Z Bathtub c) Urinal Gas Piping 0 Boiler 7 Lavatory(Wash Basin) 1) Drinking Fountain 1 Water Heater Refrigeration j Shower O Floor Drain / Gas Fireplace 0 Wood Stove i Kitchen Sink&Disposal () Grease Trap I Gas Range /0 Ducting / Dishwasher 0 Roof Drains / Clothes Dryer Hookups Other / Clothes Washer C) Medical Gas / Range Hood / Water Heater Other I-I Exhaust Fan 11. Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Number of Heads ACKNOWLEDGEMENT:t 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.lam 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 17/11017/471.41./(11 2- /6 — r6PEMIT# Cinl i•,a 1t Owner/Authorized Agent Signature Date (Revised 10/122015)