1731 LOMBARD AVE 2019-07-24 - Laserfiche WebLink

4-77 PERMIT APPLICATIOI I BUILDINIS.IIIECHANICAL / PLUMBING / SIGIWI' UPRINKLER/ 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: !-7 77 1 Loijil, -/(J /4'1`,L PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: PNIf✓ A-IZ D 5',/v2,-1, "T J7 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET i73/ L0.,-L-L/cAve GOA CITY //ter (' STATE wA ZIP C7S'42f.V OWNER PHONE: .1.\v pp C•—L—LlE:_n ER(bA CONTRACTOR NAME: Scr.yfile-e (S Sc -- i CONTRACTOR ADDRESS: STREET `� 173c j( 33-7 7 C, ) 7 CITY 5�r;t{'I lit-`')A- C �/ �J c� STATE ZIP CONTRACTOR PHONE: O I7 W-..--/�^7J CONTRACTOR? EMAIL: moi{, G. c p, iL re 1,- 1 i•}, . , CONTRACTOR LICENSE#(REQUIRED): /31/ .PI-'J P L 771(3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (jC'yi 3 PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: ! -� CONTACT PHONE: 7—S L —I 5 13)a-a,--"241 CONTACT EMAIL: se �}/,�(CA-r-v 'I- Lc.)"-1 1 BUILDING INFORMATION Existing Use of Building: 5; LJ-6,-1,114--/ I Contract Price of Work: $ 7 i' K/. /5 Proposed Use of Building: P 5, vi�.f '6"'1 Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Sg e $ - ( 4-c 4' t fldt[z�i D,,. ap,c, - bD1a5 ��ISr- �, ke.�S �,,, 1 /ASSOCIATED BUILDING PERMIT#(if applicable): i 1 MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture List of Fixtures Fixture Count Count List of Fixtures Count List of Fixtures Count List of Fixtures 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 Ventilation 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 iGas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression SystemNo.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 4. �Li;- `, L//i0,1.01 ; P IT#�au _ ClL1 (` Owner/Authorized Agent Signature Date (Revised 10/10/2018)