1518 MADISON ST 2019-07-24 - Laserfiche WebLink

ISM i PERMIT APPLICATION BUILDING / MECHANICAL/ PLUMBING /SIGN I SPRINKLER/ DEMOLITION EVE R E T T CITY OF EVERETT PERMIT SERVICES 32005 CEDAR STREET,EVERErT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everethrra.gov www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 19 Yhc,eJlben F-\-- i 'S( PROPERTY TAX#: LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET CIN STAT_ ZAP OWNER PHONE: 1 l OWNER EMAIL: CONTRACTOR NAME: tv A -tec,AYLc ct,„A ' Ur- CONTRACTOR ADDRESS: sreEET ;S 00\ 1 'A -t( (\ CITY C.42-+r9'i0r9. SrArE Vi!`. Z 1 J:J 2,:1 CONTRACTOR PHONE: P-0 Cot 1-)Sto 0(00\ CONTRACTOR EMAIL: e.{3Hr^.'.1 al ''r0,-)z o OS . (.O w1 CONTRACTOR LICENSE#(REQUIRED): i`r f—T7' 7 n :f o MA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 1; Z1) , PRIMARY CONTACT: tErOWNER ❑ CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: BUILDING INFORMATION Existing Use of Building: Contract Price of Work: $ Proposed Use of Building: Heat Source: ❑Gas ❑Electric DOther BUILDING USE: ❑SFR ❑Townhouse ❑Duplex DADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New DAddition ❑Remodel ❑Repair DT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: C,In 0...n Ot q L.,ar.�, -\ 4 �V -le c.-‘-aL 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 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 HeaUAC 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 of Heads Chemical Suppression System 1__ jNo. No.of Heads ACKNOWLEDGEMENT/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./am the owner,or/am authorized by the owner of this property to perform the work for which application is r and I comply with the State Contractors Law 18.27 RCW and 296.200A AC. City of Everett Official Use Only PERMIT# Etc)0c -c \ Owner uthoriz d Agent Signature Date (Revised 4/15/2019)