2201 16TH ST 2019-07-09 - Laserfiche WebLink

PERMIT APPLICATION BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES "* gj 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: 2201 16 owm Eveq, t.v4 71201 PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: C, pr12 eve,44 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 21.9 iA/ wo c /4' CITY EVcrc+-1- STATE (VA ZIP V20/ OWNER PHONE: (12 5- 32$ OWNER EMAIL: jr„,cilety .pov CONTRACTOR NAME: Brtrfati t o„tr, , CONTRACTOR ADDRESS: STREET—9rt Thal , CITY 1 ca K ,\/ _I•_, STATE 1010 ZIP '9f96 CONTRACTOR PHONE: 2.06 S73 8626 CONTRACTOR EMAIL: evak@ , , �{ ,P„.wet' CONTRACTOR LICENSE#(REQUIRED): 8((R70Nc1fis39 M 2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):0j'3Q3 f PRIMARY CONTACT: ROWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: - 324 144-9 jos,(OhL,/ t^� , it t ro14- rt,etim, CONTACT EMAIL: � cr`l 4 tVG/Y �ve[ikptrtee BUILDING INFORMATION Existing Use of Building: 'Pr'+,.e S(s f, Contract Price of Work:$ 4 tYre7,vv, Proposed Use of Building: 61,f-k Heat Source: ❑Gas 12rElectric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ISCommercial ❑Accessory Structure Type of Project: ONew ❑Addition2emodel ❑Repair CIT.!. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: pe 4J 2 + 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 NC—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.1 am the owner,or 1 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 PERMIT# r6/fo3�0��- 9.0W Authorized Agent Signature Date (Revised 10/10/2018)