2711 MAPLE ST B 2019-06-25 - Laserfiche WebLink

PERMIT APPLICATION ellilliPAV--0,--41 BUILDING/MECHANICAL/ PLUMBING/SIGN /SPRINKLER/DEMOLITION ARV 4.1gw-j. 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 1 www.everettwa.gov/permits (Blue or Black Ink OnlyPlease) PROJECT SITE INFORMATION. PROJECT SITE ADDRESS: &7// ,„ 2q��-- PROPERTY TAX#:0l0,97gaaa4/{9 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: l,/�/y( A)--- TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET Tv�w.��JC�C/Cr Y STATE "4 ZIP OWNER PHONE: .025.----.7/ ----- /2 OWNER EMAIL: 6- O,,4 "----1.,/6...., ) --...././.0,/ CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: c : WNER 0 CONTRACTOR 0 OTHER(Please Specify) C T NAME CONTACT PHONE: ,pc1.€-- CONTACT EMAIL: BUILDING INFORMATION Existing Use of Building: 51-.Ft/ Contract Price of Work:$ co Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: El Commercial ❑Accessory Structure Type of Project: ONew ❑Addition ❑Remodel ❑Repair ❑T.I. OSign ❑Sprinkler ODemolition ❑Change of Use DESCRIPTION OF WORK: D learnive-- g-(3rT o , ccecf y i7S . ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures 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 Ventilatior 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. �-111111 City of Everett Official Use Only PER )TOwner/Authorized Agent Signature Date (ReviseeCdd 10/W10/2018)