1611 23RD ST 2019-06-12 - Laserfiche WebLink

477- PERMIT APPLICATION BUILDING ECHANICAL/ PLUMBING / SIGN rig RINKLER / DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT6) )SI.ADDRESS: PROPER0TY0T4A31 j 4 79 O 1 7b l LEGAL for new construction: Short JPlat/subdivision gi)of g f L4 1--lYD -61 Lot NoYi(S,(q(attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 51 X j 1h1 174 if.N(7€dbj;45 j ri C,. TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5173 {i WP -7I 1('1s' P.5 01 TE ITB //��1 a cITY lj ii'N 12/C&o STATED/ILI F. ZIP 7ILIL(3 OWNER PHONE: OWNER EMAIL: 31i, ni3Ojy(f/[?bi< .le,,_ CONTRACTOR NAME: / 0611-61a... G/-}-V(66 W)/11 NTEtA °NJ Ce Q/ C J1 P7 C. C H CTI ii& LLG CONTRACTOR ADDRESS: STREET 3 is t, 2,) r c_k - c--- c rri, CCITY Z.:V`2 L1 STATE LA3 Cr ZIP Cl‘0(1:03 CONTRACTOR PHONE: 7/.1 - 4 l"1 14 3 CONTRACTOR EMAIL: elbG)11q G 15 .0 rn'vIL • ciavy3 CONTRACTOR LICENSE#(REQUIRED): e 136-B5C., G IL CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): U�/`f G(Cy PRIMARY CONTACT: ❑OWNER ❑ CONTRACTOR AOTHER(Please Specify) '-f1 -C71-- CONTACT NAME:�, p CONTACT PHONE: 1 --- 2 3 V3_ J7 IA/ wtl rim I rj CONTACT EMAIL: rQcie q�G L] a(A)fll Ct1O cti I 'lCj\-1.4 • L 0I'll BUILDING PERMIT APPLICATION J N bit: Existing Use of Buildings rG)f)"YvI 1 L Y Contract Price of Work: $ I ii/ 49.2C) � Proposed Use of Building: )/J 411r.� 1 /'IY1 I Irl Heat Source: ❑Gas 'Electric DOther Building Type: ❑SFR-Detached , SFR-Attached ❑Duplex ❑Multi-Family-#of Units: DCommercial ❑Industrial Type of Project: ❑New 0 Addition Remodel DRepair ❑T.I. DSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 1470 13/ITI t/Zobrn /ri.J' GLbs /N IA• 5n7T ,t�avy) W/&/POS s ' 17fi ser ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New _ Addn Alteration _Repair Type of Project:KNew _Addn XAlteration _Repair #of #of List of Fixtures #of List of Fixtures #of List of Fixtures List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump ? Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit HeaterI Bathtub Urinal _ Gas Piping Boiler 3 Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration r Shower Floor Drain Gas Fireplace Wood Stove 1 Kitchen Sink&Disposal Grease Trap Gas Range • Ducting j Dishwasher Roof Drains Clothes Dryer Hookups Other: J Clothes Washer Medical Gas I Range Hood Water Heater Other: Z, Exhaust FanSink(Service/Bar/Mop/etc.) Other: SPRINKLER/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 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 comply with the State Contractors Law 18.27 RCW and 296.200A WA C. City of Everett Official Use Only PERMIT# j "1) 1-- Za • lb C ( 0i (C0 - 60 Owner/Authorized Agent Signature Date (Revised 10/12/2015) kfZ�