2414 CLEVELAND AVE 2019-08-07 - Laserfiche WebLink

PERMIT APPLICATION BUILDING / MECHANICAL/PLUMBING/SIGN /SPRINKLER/DEMOLITION CITY OF EVERETT PERMIT SERVICES 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: qr q,4' ez V�j/(4) ,t2& PROPERTY TAX#: LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: IdersLG 'f rI g4C V-V JO_ti4 TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET1/d 4 u $ ` , CITY Eve RE T--r- STATE x,/�l A ZIP - — OWNER PHONE: I -2$ q 'YYc7 OWNER EMAIL: CONTRACTOR NAME: �(f cSO CS(ZCLr Se'J -/J GL.S L,LC- CONTRACTOR ADDRESS: STREET/9:4:73 S/L"Wif$-T /2-0 CITY m/Lie STATE I/JF *- ZIP 783 56 CONTRACTOR PHONE: 4/2f 5/k,-4/3 f CONTRACTOR EMAIL:&LL.'y. Of te: -X-4"/"G"- Zf$d'C0,1 CONTRACTOR LICENSE#(REQUIRED):_.JIIF124 sL g7!C 49- CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACTnnNAME: , '' ,\ `' CONTACT PHONE: 112_5-- !�/ y3 E O 4I2)( NJ C U� K� CONTACT EMAIL:ez%2J y, (G 1C (O� —( 1 SC'.C-0'f BUILDING INFORMATION, I Existing Use of Building: Contract Price of Work:$ 1606. G 0 Proposed Use of Building: Heat Source: )2/Gas DElectric ❑Other BUILDING USE:121SFR ❑Townhouse ODuplex DADU 0 Multi-Family-#Units: ❑Commercial DAccessory Structure Type of Project: ONew DAddition DRemodel DRepair DT.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Z L��v_Eor of rI*�i-G,,kS M(T Z ) 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 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.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 compl h the State Contra tors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PEfjM r#I1b±O 0 r/Auth rized Agent S"•nature Date (Revised 10/10/2018)