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2410 TAYLOR DR 2020-01-21
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2410 TAYLOR DR 2020-01-21
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Last modified
1/21/2020 9:31:20 AM
Creation date
7/9/2019 7:49:33 AM
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Address Document
Street Name
TAYLOR DR
Street Number
2410
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PERMIT APPLICATIO <br /> '111111*/A:"./;7‘ <br /> BUILDING I MECHANICAL I PLUMBING I SIGN I SPRINKLER I DEMOLITION <br /> NINIIIWICITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 7ji 1 O 1 Kw. 1 W PROPERTY TAX#:0 O LI 1-i 0002-0( 13 2 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Lark 50) ( ,V\42,(/( TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 24(0 ( se1--' r <br /> LI( CITY E V /�t" STATE l�A-t , zip 3 � )3 <br /> OWNER PHONE: `I ALV 1g 0 tt.."LC 3J 2 OWNER EMAIL: <br /> `n n�G(i�✓-G1..G1 7 t0 cm e II�p4ivioti( . ( Ito <br /> CONTRACTOR NAME: Uv\f1, �{ �) ( t.o&4 'v c Dil)vvcLI A usn.sivt�(..CiiiaYI) <br /> CONTRACTOR ADDRESS: STREET ¶) .0, B c X ''4 13 <br /> CITY Y vy�iA z ( 4 f STATE � ! \ ZIP 9 B ?1 S <br /> CONTRACTOR PHONE: j2.5' 33//0 o1 Sg I CONTRACTOR EMAIL: ‘/1/l, -�-�j e QO' . (pu..�1/1/,I( <br /> CONTRACTOR LICENSE#(REQUIRED): CA , W C M ( 33L CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): '`ill �/ <br /> PRIMARY CONTACT: *OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: (-, sx-eR Contract Price of Work:$ (,/(000 <br /> Proposed Use of Building: Heat Source: ll\IGas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition j$Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: k,p 611/44+1 <br /> L1 \ 1_ l <br /> ;Ct;l `LAfrt.c.. -e5 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn X.Alteration _Repair Type of Project: New _Addn X_Aiteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #°{ List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove ! Kitchen Sink&Disposal Grease Trap <br /> I Gas Range Ducting t Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> ( Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I No. of Heads • <br /> 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 <br /> 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 <br /> Building Official before being authorized under any circumstance.I am the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> CityCiitof Everett Official Use Only <br /> IyPERMIT ( C�0 *-OO I <br /> Owner/Authorized Agen Signature Date (Revised 9/23/2016) <br />
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