6203 W MAGNOLIA AVE 2020-01-21 - Laserfiche WebLink

IIII IIII PE,-MIT APPLICATIOji II 'IP* is UILDIF1 I MECHANICAL/ PLUMBING I SIGN/ gPRINKLER I DEMOLITION '+ t 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 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:(020"`5 co mukr,01iA Mt clexe-# 142,05 PROPERTY TAX#: OO4D120006 10406 LEGAL for new construction: Short Plat/subdivision J Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:—rOm 044 iDQs.‘7t G0. Z'ey1se•,N� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET (p9...05 It) m&s,& o.. ANC, CnY Evese.'M- STATE (,V F} ZIP 1%245 OWNER PHONE: 925— xis— OWNER EMAIL:dQhItaJen .lr se �+ �� ex%A •CelY1^ CONTRACTOR NAME: 0 tAi ti&rte IM 0..,14 'Vow\i r 0. —312-men CONTRACTOR ADDRESS: STREET • CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: )OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACTONNAME: CONTACT CONTACT PHONE: q25 273_N63'\ ` .L�i.+t�.CA. Je-�SC't‘ CONTACT EMAIL: AAhi(e.J ?Y n,t." �ZmA.X•feM BUILDING PERMIT APPLICATION Existing Use of Building: eeiv},A\ Contract Price of Work:$ 2Oldpp.� - 25oAA•� Proposed Use of Building: Rk,tAika1 • Heat Source: ❑Gas ($(Electric ❑Other Building Type: JSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ,ddition ❑Remodel ❑Repair ❑T.I. DSign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Single -com113 re once addl•Kon 0cC 33(0to include. A,AV t01i "tient bo‘lcirt and QlomkArt. 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 #°f List of Fixtures #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures NC—Air Handling Units Heat Pump ' Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Z Unit Heater Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration I 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.1 am the owner,or I am authorized by the owner of this properly 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 PERMI V V2- !C° ( ...Owner/Authorized Agent Signature Date (Revised 9/23/2016) "")