Laserfiche WebLink
PERMIT APPLICATION <br /> BUILDING/MECHANICAL/ PLUMBING/SIGN /SPRINKLER/DEMOLITION <br /> I�►���_ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I E everetteps@everettwa.gov lwww.eve <br /> www.everettwa.gov/permits <br /> v _ PROJECTr SITE ISI "ICON .., <br /> PROJECT SITE ADDRESS:5521 Ocean Ave,Everett WA 98275 PROPERTY TAX#. 00731700002200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACTtI,NFORMATIO <br /> OWNER NAME: Yuri Kozodoy TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 4997 Brighton Place <br /> art Mukilteo STATE WA ZIP 98275 <br /> OWNER PHONE: 425 876 6764 OWNER EMAIL: yuri@umbrellagroupllc.com <br /> CONTRACTOR NAME: Umbrella Construction Inc. <br /> CONTRACTOR ADDRESS: STREET PO BOX 1245 <br /> cin. Mukilteo STATE WA ZIP 98275 <br /> CONTRACTOR PHONE: 425 876 6764 CONTRACTOR EMAIL: Yuri@umbrellagroupllc.com CoA ek+4' <br /> CONTRACTOR LICENSE#(REQUIRED): UMBRECI934PN CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): )- (11 ,, <br /> �� <br /> PRIMARY CONTACT: II OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> .. ...�, ._. _ �'. -_ <br /> fy) <br /> CONTACT NAME: CONTACT PHONE: 425 876 6764 <br /> Yuri Kozodoy <br /> CONTACT EMAIL: yuri@umbrellagroupllc.com <br /> .i a,.,:: 01I�:001:000011`+tuPPhl+>rA1'I:0N 4 <br /> Existing Use of Building: Single Family Res. Contract Price of Work:$ $19,600.00 <br /> Proposed Use of Building: Single Family Res. Heat Source: I71Gas OElectric ❑Other <br /> Building Type: ®SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: OCommercial ❑Industrial <br /> Type of Project: ONew MAddition ORemodel ORepair OT.I. ❑Sign ❑Sprinkler ©Demolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> New addition above existing garage and family room <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PER I T AP CATIQN PLUMEING PER IT APPLIil:ATION,,. <br /> Type of Project: _New Addn _Alteration _Repair Type of Project: _New _g Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #°f List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump 2 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater 2 Bathtub Urinal <br /> Gas Piping Boiler 3 Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration 1 Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> 3 Exhaust Fan Sink(Service/Bar/Mop/etc.) Other. <br /> S 'RIIN ER€ SUPPRESSI. N S` T'EM <br /> Number of Heads <br /> 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 <br /> 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 <br /> Building Official before being authorized under any circumstance.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.2004 WAC. <br /> City)of Everett Official Use Only <br /> ./ it <br /> 1 2 0` b PERMIT#�; <br /> XV/ <br /> (01 <br /> Owner/AA Jthori ed AgentS Signature Date (Revised 10/12/2015)/ Vj/Vd/ <br /> � t <br />