5017 23RD AVE W 2019-06-12 - Laserfiche WebLink

4.77' PERMIT APPLICATION BUILDING / MECHANICAL I PLUMBING / SIGN /SPRINKLER ! DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 I(E)everettops@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: '3(.51 7 2.3yei /1V t°- W PROPERTY TAX#: LEGAL for new construction. Short Plat/subdivisfonLot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Spaki tr TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 017 2- w Ave,, L s^^.r" /�►L+i) STATE ^'r'T De cis t.✓ OWNER PHONE: 4 -is 5 { D 3 111-+(e? OWNER EMAIL: CONTRACTOR NAME: CAM CONTRACTOR ADDRESS: srl<eer 5'4i ocd CDY e,# STATE WA ZIP C CONTRACTOR PHONE:Li35 A59 C>5—j.) CONTRACTOR EMAIL: d le s(Dc 1'trieCI. `1' a , COM CONTRACTOR LICENSE#(REOt1IRED): lr.f► /vita rlth -rut ri CITY OF EVERETT BUSINESS LICENSE#(REQUIRED). !Cpt t43 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify)_ _ _.__W._,_._e CONTACT NAME: CONTACT PHONE: LIZ 1159 F-- p2,bibt.e.) ,,t CONTACT EMAIL: a 3(..e, L:l cm,,Yt�-'t,.�. tit1q .t0 M BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$. 4p'f t- C Proposed Use of Building: Heat Source: s ❑Electric DOther Building Type:AsFR-Detached ❑SFR-Attache9 DDtiplex ❑Multi-Family-#of Units ❑Comrnaroial ❑Industrial Typo of Project: ❑view ❑Addition ❑Remodel DRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: el heiotaxiL Cfk5 r ctCQ ASSOCIATED BUILDING PERMIT#(if eppliceble): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New 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 Heat Pump Toilet Backflow Preventer(Inside Bldg) 1 Forced Air SystemsUnit 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 I SUPPRESSION SYSTEM Chemical or Water 1 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.lam the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, and I comply with the Stele Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only . PERMIT# I i. 0; g‘� i1 i d•iq•(7j 'Own() /Authorized Agon ignature Date '{Revised 9/23/2015)