616 OLYMPIC BLVD 2019-07-08 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/PLUMBING /SIGN/SPRINKLER/ DEMOLITION �� CITY OF EVERETT PERMIT SERVICES ' ' J 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 SITEiNFORMATION PROJECT SITE ADDRESS:616 OLYMPIC BLVD PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: KELLY WHITE TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 616 OLYMPIC BLVD cnY EVERETT STATE WA zip 98203 OWNER PHONE: 425.308.2727 OWNER EMAIL: CONTRACTOR NAME: EYLANDER SALES & SERVICE CONTRACTOR ADDRESS: STREET 3601 EVERETT AVE cry EVERETT STATE WA zip 98201 CONTRACTOR PHONE: 425.259.2161 CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EYLANSSO42K2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):016363 PRIMARY CONTACT: pi OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425.308.2727 KELLY WHITE CONTACT EMAIL: BUILDING PERMIT APPLICATION Existing Use of Building:SFR Contract Price of Work:$1500 Proposed Use of Building:SFR Heat Source: OGas DElectric ❑Other Building Type: VISFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel ®Repair ❑T.I. ❑Sign OSprinkler ODemolition ❑Change of Use DESCRIPTION OF WORK: REPLACE GAS HOT WATER TANK 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 #°f List of Fixtures Fixtures Fixtures Fixtures Fixtures O NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal it 0 Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain 1 Water Heater Refrigeration 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 INo.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 befo .being authorized under any circumstance.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made, and I comply with State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only /0,1/( PEAL 10 09 Owner •Lit orae. •ent Signature D (Revised 9/23/2016)