8020 W GLEN DR 2019-07-08 - Laserfiche WebLink

eilliP.,, PERMIT APPLICATION BUILDING/ MECHANICAL/ PLUMBING?SIGN /SPRINKLER/ DEMOLITION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: y°OZt) 61Q/1/ be. PROPERTY TAX#: ce)07/ogoQCoIs©O LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: (h/ /Zinscryt TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 202© co 6LeAA 017 CITY L'- ` STATE LA J pF ZIP Qf 203 OWNER PHONE: 17/2 30e-Os-'// OWNER EMAIL: CIT-9/2 93 ,6/11q-,1 I . Cr,vn CONTRACTOR NAME: lL f (dO i{f jC CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: XOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING INFORMATION p Existing Use of Building: Contract Price of Work:$ !s CY/ 7o Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE:.TSFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ONew DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 1plaC/A6 5xrs7-i•v6 17 L1i 7 5Ac e:11// D �u t 1/ rc-n(LeX 1.\/ (-0 A4-7-t) carnes lu 14 bock•, G, e_ou eg ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture Fixture List of Fixtures List of Fixtures List of Fixtures List of Fixtures Count count 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 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. / City of Everett Official Use Only PER _ �� 6‘03... 044 • ner/Authorized •gent Signature Date (Revised 1010/2 18)