5309 23RD AVE W 2019-06-12 - Laserfiche WebLink

457-1- PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 63o62:6C-j-::: t:',N k- \\i PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ' Ir_,IC-ONTACT INFORMATION OWNER NAME: A- _ & -' f/t- �(jlvC'vl TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5301Q , \PJ r _CHIT STATE iti\TY ��(g'V l ,i_ ZIP q�� i © OWNER PHONE: Cmc•21-A ° 44 I OWNER EMAIL: CONTRACTOR NAME: rGZ.•R-CLY X 4r- A..*w 4 ijdy'Y _ I 56L(A.---() S l VA CONTRACTOR ADDRESS: STREET PU0yt " Gig CITY KA.5 ��,,� Cs V 1.1 STATE_ 4��.. ZIP,, �.l g2:91,2 / CONTRACTOR PHONE: V• //C� CONTRACTOR EMAIL: I1("1 U0 e .. �lrl Y UC.-di ex-w� CONTRACTOR LICENSE#(REQUIRED) �C.) t✓g c �!(-t CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 05", L PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME CONTACT PHONE: &.Pd ,Ltkcg • I bo 1 I\.9 Pa.;1,,,_ tvC'., \ CONTACT EMAIL: 1 irk fD CO •pA_P- ctr 4N v,- ..c 4.i KY`°+ BUILDING PERMIT APPLICATION �, � Existing Use of Building: Contract Price of Work: $ li4 ' Proposed Use of Building: Heat Source: I Gas ❑Electric ❑Other Building Type: ,SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel 0Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: .�1, .e, --f v iLa. _ IA ke_ era 4.1\_A 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 List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C–Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) p 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 Water Heater Other: •Exhaust Fan Sink(Service/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 com•y with t�to Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERM # �—� � �� w f I \ O2,, Owner/Au I orized Agent Signature I Date (Revised 9/23/2016) 9 9