3228 HOYT AVE 2019-06-25 - Laserfiche WebLink

• ) - 7•,)0,, "IA PERMIT APPLICATION TO BUILDING BUILDING i IUIECHANICAL / PLUMBING / SIGN / INKLER / DEMOLITION OF EVERETT PERMIT SERVICES Err3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) f PROJECT SITE INFORMATION T� PROJECT SITE ADDRESS: 32 Z J/c�=1 / 't CveL r./; LJ 4 `167c`/ PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: j)C 74-A,l ..)C:;/./A:_:.>,,J TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 2 7/7 r I/ri fi:Z r S i•jai �tdir. CITY /':::c } C,�J 71-t:: r STATE Ll�o� t ZIP qQG v`/ .,5 7 s/_ OWNER PHONE: 111.5— p2 l a, OWNER EMAIL: ilea_`} j ."M CONTRACTOR NAME: O+�'�i=T'- CONTRACTOR ADDRESS: STREET C,!TY STA1 E ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REOUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR 0 OTHER(Please Specify) __-__._- CONTACT NAME: CONTACT PHONE: I-Zy zq 9)- tj•.1.5"" M ii-11 CA— 1CONTAC T EMAIL: /"( etit.;,,:, L13-fe-.-yGLc t ✓e.:.:7fsii-•c ..::,, BUILDING sail S?1 MATION Existing Use of Building: iCortract Price of Work: $ 0 `'i P t`c.:,-.:-. i/ ` -Y 26 ( Proposed Use of Building: leat Source: GIGas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADL! ❑M!a'-Fara'sly_#Units:__ ❑Commercial ❑Accessory Structure Type of Project: ❑New DAddition ❑Remodel 0Repair LI i.i ❑Sign DSprinkler ❑Demolition OChange of Use DESCRIPTION OF WORK: / 4ova Dat4 t' Ck f'E�r'i. pt ASSOCIATED BUILDING PERMIT#(if applicable): _.-a„_- MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture F;,,,,,e Fixture Fixture List of Fixtures List of Fixtures List of Fixtures List of Fixtures Count Cor Count Count A/C-Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER / SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System 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 I/4 IlI i( / PERMIT# IC � C ? 003 Owner/Authorized Agent Signature Date (Revised 10/10/2018)