11325 19TH AVE SE 2019-06-11 - Laserfiche WebLink

Oct 03 2018 12:57PM Washington Wateeaters 8663757454 pages PERMIT APPLICATION BUILDING 1 MECHANICAL I PLUMBING (SIGN I SPRINKLER/ DEMOLITION ' /-1 CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everelteps-eeverettwa.gov I www.evereltwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 1 L Z6 te4 Prti.e .*Z 1`l0 PROPERTY TAX#:CLIriOWSOLivi,100 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Cd TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREE 15 Ii'" 1-] )&- CITY x'P.tt sr,Te t pt zip ,ac) ' OWNER PHONE: 'OWNER EMAIL: CONTRACTOR NAME: W 50 t A)6)76/1/4-1 GJ A-1---612. H6-6-7-6-fej CONTRACTOR ADDRESS: STREET I1I�J L. a L - 4-r C. — frG box �6926 6 cm, P' l �/7 1 STATE 1/"i`+ ZIP 9,O V 51( CONTRACTOR PHONE: 42640— qt 71 CONTRACTOR EMAIL: WIi-j J611`/19C 1"6/mi1/L., (cm CONTRACTOR LICENSE#(REQUIRED): 14.),4 iWklg'f p CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): OS dViiki PRIMARY CONTACT: 0 OWNER 1 CONTRACTOR ❑OTHER(Please Specify) • CONTACT AMECONTACT PHONE: �2 �g�3-70 7(ssi1 ^ nf-C IS CONTAT EMAIL: tON-j4.49.•#4./ .Igi 641-4....um BUILDING PERMIT APPLICATION ExistingUse of Building: a4 g Contract Price of Work:$ IA 00• Proposed Use of Building: Heat Source: ❑Gas jatElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑industri- .A Type of Project: ❑New ❑Addition °Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use lel E a6 DESCRIPT ON OF WORK: 6mor.e. cd_. ,-eipii_a_ 1 Eleck-06 weriei-./-zw-crys) ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION __pff Type of Project: _New Addn _Alteration _Repair Type of Project: New „_,Addn Alteration Reps 4,`YL� #of List of Fixtures #of #of #of uYL Fixtures List of Fixtures List of Fixtures Fixtures Fixtures Fixtures List of Fixture A/C-Air Handling Units Heat Pump Toilet Backfiow 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 Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood i Water Heater Other: Exhaust Fan _ Sink(ServicefBarlMopletc.) Other: • SPRINKLER I SUPPRESSION SYSTEM Number 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 cunni federal,state,and local law. The granting of a permit only author!.: approved work and no deviations therefrom.Deviations must first be authorized In writing from The Building Official before being authorized under any circumstance.tem mner,ort em authorized by the owner of this property to perform the work for which application Is made, and r comply wen ma SluIo contrae:ore LOW 18.77 - 16 IW end 290.200• C. City of Everett Official Use Ony �ai•,% I i itPERI f I) � V ' C� Owi /Authorized Agent Signature Date (Revised 5J20/2015) v