2410 MAPLE ST 2019-06-25 - Laserfiche WebLink

PERMIT APPLICATION BUILDING I IRCHANICAL / PLUMBING / SIGN /UH2INKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 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 P a f, PriROJEGT SITE IT,FORMATION , n ayN moi' ;' r. PROJECT SITE ADDRESS: iv PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) l !" ",. �n A , CCT IN ONTAFORMATION r OWNER NAME: 'v AW A. RC at/L TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 24(t ritp` 34- J� " 6ce CITY STATE //JS ZIPZOf OWNER PHONE: 1425—25Aj-`'i—fer4(� OWNER EMAIL: �/ 111 CONTRACTOR NAME: VO4..(/r CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ›.INNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: .- 20 '-'- t.' "L / �/ � • A - +' CONTACT EMAIL: �Ck_rJI g. aX-int.'s) Rw ,, ! UILDING ERMITAPLI:CA10N 'P , Existing Use of Building: ( i"—" Contract Price of Work:$ 4(P t 3 6 9 Proposed Use of Building: ,AD ,..A_. Heat Source: ❑Gas ❑Electric ❑Other Building Type: WR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: zniN� '�C�tA&,111G( tc Cie f pk.,, trtCt i Ve.A4-l-i WCC j (t�5oI0.+I`t ,.. 21-iv�+ev''vNtvt ,P.A _nQr cY&44rjSi— I ,Se V1 J Re T 7wd P 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-itt3C j Toilet Backflow Preventer(Inside Bldg) Forced Air Systems 4--' Unit Heater ( Bathtub Urinal Gas Piping Boiler ( Lavatory(Wash Basin) Drinking Fountain ( Water Heater Refrigeration Shower Floor Drain Gas Fireplace _ Wood Stove j Kitchen Sink&Disposal Grease Trap Gas Range Ducting Dishwasher Roof Drains ( Clothes Dryer Hookups C Other:e$takt} ( ,,,-Clothes Washer Medical Gas I Range Hood - h Water Heater Other: I Exhaust Fan I- (Ayt, V Sink(Service/Bar/Mop/etc.) Other: SPRRINKLE /SUPPIORESSN YSTEM 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 authoriz•.unde 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 •h the State Contra ors Law 1:.27 RC .nd 296.200A WAC. City of Everett Official Use Only I,/� / PERMIT# I Owner/Author A e Signature f Da (Revised 9/23/2016)