4925 NARBECK RD 2019-08-07 - Laserfiche WebLink

fr PERMIT APPLICATION BUILDING / MECHANICAL / PLUMBING 1 SIGN / SPRINKLER / 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: C/ a PROPERTY TAX#: 0041 7060 g 3 L LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)CC A'"I l/\t t1I CONTACT INFORMATION OWNER NAME: ?/{C 0/4 V‘S TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 4-CJ Zc Mi-gPj?`c 12.-0A - CITY ��-t��-FF STATE ki A ZIP Q 3 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 01,✓n er- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR p OTHER(Please Specify) t\ . I4 I T c,.i CONTACT NAME: SA QA,i{ 11+0 Yh PS 0A3 CONTACT PHONE: +Z S- 1�4 C'- 2 7 5-- Km —K12.m Boberef,AS`ir(SC‘RCFES CONTACT EMAIL: ^,Ct tral),e V>?•XrC��I BUILDING PERMIT APPLICATION Existing Use of Building: 1151 1;)e".i; I Hc. Contract Price of Work: $ L`; COL, ` ` Proposed Use of Building: S I D-CN �-1f�L Heat Source: ❑GasJElectric DOther Building Type: :I,SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: DCommercial Dlndustrial Type of Project: ❑New ❑Addition p.Remodel ❑Repair ❑T.I. OSign DSprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Nmei op_ t� Yldl - /� ' 12,07�1 i>1 c:tC Ii1Bp/i_„ , cz 1,,�jt1l�IZt+I iLSJ ,JCvv ts c cD DEtK- f};eIRA-DF ASSOCIATED BUILDING PERMIT#(if applicable): 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 #of List of Fixtures #of List of Fixtures Fixtures Fixtures Fixtures _ Fixtures A/C-Air Handling Units _Heat Pump E Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler I Lavatory(Wash Basin) Drinking Fountain Water Heater \�"\( \Refrigeration Shower Floor Drain Gas Fireplace Wood Stove I Kitchen Sink&Disposal _ Grease Trap Gas Range Ducting i Dishwasher Roof Drains I Clothes Dryer Hookups Other: j Clothes Washer Medical Gas Range Hood Water Heater Other: I Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER/ SUPPRESSION SYSTEM Chemical or Water 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 C_J _ PERMIT# ` 9 /1r1l Owner/Authorized Agent Signature •.1 Date (Revised 9/23/2016) 1