2729 12TH ST 2019-07-30 - Laserfiche WebLink

PERMIT APPLICAT IO111_ - BUILDII— MECHANICAL/PLUMBING/SIGN ' RINKLER/ DEMOLITION 14410( CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 2,121 1 .2_7'-, ,'S PROPERTY TAX#: Z.gO S ) 7O0 10 3 2O? _ LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: EVZt�� Ii-Dos) 0 Z t—Pr , TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET `J�N- f o'--7 Col 1j� cL cr, -__Jt.-..-.12_E STATE WA- ZIP 9 B G_S J i OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 713 D. CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: RI/OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (-f2:5-- 21"3 - 1 MO- ©',icy 40--S--. / k\---- 4,),t-LT- CONTACT EMAIL: , -pW c- i k Q____ .c.?__,"1„‘4, ' (5_,—,1 - BUILDING PERMIT APPLICATION Existing Use of Building: }-'v-e_e-i S Contract Price of Work:$ l 0 . Proposed Use of Building: Sft-svtE �Heat Source: ❑Gas El Electric El Other Building Type: ❑SFR-Detached ❑SFR Attached ODuplex 1vlMulti-Family-#of Units: Li El Commercial Dlndustrial Type of Project El New DAddition DRemodel ❑Repair DT.I. DSign ❑Sprinkler DDemolition ❑Change of Use DESCRIPTION OF WORK: , - P noFerJ ASSOCIATED BUILDING PERMIT#(if applicable): *. v165-5- 051 MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Type of Project: New Addn Alteration Repair Type of Project: _New Addn Alteration Repair #of List of Fixtures #of List of Fixtures #°{ List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures Fixtures A/C—Air Handling Units Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler 9 Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove ki Kitchen Sink&Disposal Grease Trap Gas Range Ducting L{ Dishwasher Roof Drains `i Clothes Dryer Hookups Other Clothes Washer Medical Gas y Range Hood Water Heater Other: eS Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/SUPPRESSION SYSTEM Chemical or Water 9 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.lam the owner,or 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 'The_ 1 NI �-- PERMIT# Owner/Authorized Agent Signature Date (Revised 9/23/2016)