1721 BAKER AVE 2019-07-12 - Laserfiche WebLink

OLT PERMIT APPLICATION BUILDIN(J MECHANICAL/ PLUMBING /SIGN/U2INKLER/ DEMOLITION 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 I www.everettwa.gov/permits (Blue or Black ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: /72/ 6/9-e6-1( ,4,./ PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: $/LJ 1,l.y PEf ik TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /72. /I !,3/9'I�i� 4-(/F lF vt-, CRY .ill STATE ki)d" ZIP f of OWNER PHONE: a0r/p-3 i—03 - OWNER EMAIL: CONTRACTOR NAME: S v\i O C' 'e r V i C e-S 0 < v\ k 014(_S k Co. [.l-P1 flf CONTRACTOR ADDRESS: STREET f 1 (o 2:7 A i r F o r- t Roo cl S v r+ C CITY v ref( STATE A ZIP 9 g 2 a -/ CONTRACTOR PHONE: L{'2S -214,5- - 2:22_2,- CONTRACTOR EMAIL: 1'1'1 h 1r' g sSS Cao r CONTRACTOR LICENSE#(REQUIRED): S N l'a S 2,L/30 t^3' CITY OF EVERETT BUSINESS LICENSE#(REQUIR :0,.)11 x'17 PRIMARY CONTACT: 0 OWNER Er-CONTRACTOR 0 OTHER(Please Specify)CONTACT NAME: CONTACT PHONE: 70/ - ._Soo --c' 757 (b/9-0) ID a to J R.3 {) CONTACT EMAIL: On L\ rC S S S C 01^C BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ f Proposed Use of Building: Heat Source: DGas ❑Electric DOther Building Type: ❑SFR-Detached DSFR-Attached ❑Duplex ❑Multi-Family#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition ❑Remodel DRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: R F H VE dLY GJ71-57--,-- erC.4'�-� J----7-0,57-4-1A___ tue.w / . ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: _New_ Addn _Alteration _Repair Type of Project: New Addn X Alteration _Repair #of List of Fixtures #of List of Fixtures #of List of Fixtures #of L' of Fixtures Fixtures Fixtures Fixtures Fixtures NC-Air Handling Units Heat Pump Toi B, low Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal 1 Gas Piping Boiler Lavatory( 1? h Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace - Wood Stove Kitchen Sink&Disp. - Grease Trap Gas Range Ducting Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Wash- Medical Gas Range Hood / Water He- -r Other: Exhaust Fan Sink( ice/Bar/Mop/etc.) c ,er: SPRINKLER/SUPPRESSION SYSTEM • Number of Heads ACKNOWLEDGEMENT:I have reviewed this application and confirm the info :tion contained herein is true and correct.Work done pursuant to this permit must comply with :urrent 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 3uilding Official before being authorized under any circumstance.I am the owner,or!am authorized by the owner of this property to perform the work for which application is made, -.1 with the State Contractors Law 18.27 RCW and 296.20•, WAC. City of Everett Official Use Only 46,........./ ... ..„. — 5-2,'-'2-0 141 M-L10 S' . C/C )wnerlAuthorized A.- Signature Date (Revised 5/20/2016)