2405 BROADWAY 2019-06-19 - Laserfiche WebLink

I I PERMIT APPLICATIONUILDINC! IECHANICAL I PLUMBING I SIGN/SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 4011111401, - 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov J www.everettwa_gov/permits (Blue Or leek Ink k my Please) OJECT SITE INF',RM-'i TION PROJECT SITE ADDRESS: Q L/Q S 6200040/9 V Eat-,e56Lf)$,' PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 2 410/ )3,@ p,Dwr ti, L LC TENANT NAME(If Commercial): ,ATIPTA-Ak- OWNER MAILING ADDRESS: STREET / L/3 in fine- CITY ,P ECITY 5/U® CV24r - -I( STATE LAI/ - ZIP 9 Z 96 OWNER PHONE: 0/44/ Q2 E/Ns4 OWNER EMAIL: o�t A ✓t e 0 re SG�.Gt.ji/2 . cewt CONTRACTOR NAME: /g L L P R, s s- PG U/M2914)( CONTRACTOR ADDRESS: STREET / / 0 I SA/7 7 (,>k 9/9-/tJ v E S-S-.0CI Y 7-0,41A/i L/9- STATE L.4)/4 ZIP 9 F/6 c? CONTRACTOR PHONE: 240G, 93 - 5 3O(, CONTRACTOR EMAIL: L Arty t,9t C I/74-5--e-pt.0/1,11/V6._GOAt CONTRACTOR LICENSE#(REQUIRED): ALL PN PP 363,77 CiTY OF EVERETT BUSINESS LICENSE#(REQUIRED): S''7 523 PRIMARY CONTACT: OWNER ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: L A RR Y ee //ct C `t CONTACT PHONE: 2 0 6 /713 S3'?6 CONTACT EMAiL: oil cif) e ettc f e' S c e- Tt/+C coal BUILDING PERMIT APPLICATION Existing Use of Building: e 6-7:9/L Contract Price of Work:$ / J 000 Proposed Use of Building: "&"7-4-/c Heat Source: ❑Gas XElectric ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: .Commercial [Industrial Type of Project: ❑New ❑Addition XRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: X4/6.7-4-14 3eti, Z./4ViQ 2 e-a. 1Voifie/' C /ase /`S' ASSOCIATED BUILDING PERMIT#(if applicable): 8 GJ ) a 0 . - 00? 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 #°f List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C-Air Handling Units Heat Pump 2., Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler 3.. 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 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 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 6 a44;41 //1) 2 - /3 -/F I IT# ido s 00 Owner/Authorized Agent Signature Date (Revised 9/23/2016)