1312 BALLEW AVE 2019-06-18 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION/1*//144.41/-- CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 (E)everetteps@everettwa.gov www.everettwa.gov/permits 4B14e or Black ii4T107.iiIy Please) ,11;:;-A:4.. ,.., PROJECT SITE ADDRESS: /3/a BALL IA) PROPERTY TAX#:0034/q{(ft03040cf oc LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION . . Z. OWNER NAME: Dr-gD.cggr5 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET l3/Z CITY STATE vtA., ZIP q 3 OWNER PHONE: LJ26--2_20._ggqg' OWNER EMAIL: CONTRACTOR NAME: OM 4- I.) rr P 'tg/4 6- 4- i06-- CONTRACTOR ADDRESS: STREET �p(, (Li /3 kv e _ ( (, _ CITY L tii0A. 000D STATE (A/, - ZIP L 803 7 CONTRACTOR PHONE: y ZS-77 –c'LIkti CONTRACTOR EMAIL: Op,✓@_DA-t(L DA)(je. Aje_'r- CONTRACTOR LICENSE#REQUIRED): J- %L f 4 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER t&ONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: /.42,5--775-(0116# 3rprQ atPF CONTACT EMAIL: /4 r .te 0 BUILDING`PERMITzAPPLICATION. _ 47: -..,. � _ � �.. nom; I s:' '.,. xisting Use of Building: " Contract Price of Work:$ t'2-X ,CV 4roposed Use of Building: Heat Source: as ❑Electric ❑Other Building Type: ❑SFR-Detached ISFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑NeW ❑Addition El Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Dept4a6 � E �� RileAdhee (1. A-iJew 5 f 4-ce ;r%) $/)11-e- LocilT10/,), 4&D 1244A) teiA7 C*s FtiA,Q r-p tvi t!ew Nvai—C--/Z_ ?'U f a2 t/ JcC Locovrwoof 6-1,-O 1410 *Gr15 4 TV Ala() 6,45 2�a Lc»ah-10,J . 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) Forced Air Systems Unit Heater Bathtub Urinal Z 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 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 —urrent 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 —uilding 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 WAC. City of Everett OfficialciUse Only 1 PERMIT ! GQ g —10g 1©D Owner/Au orized Agent Signature Date (Revised 9/23/2016)