625 PECKS DR 2019-08-08 - Laserfiche WebLink

(477. PERMIT APPLICATION BUILDING / MECHANICAL I PLUMBING / SIGN I 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 Gj l� PROJECT SITE ADDRESS: 1-16k6.2 5 i�i V42_, PROPERTY TAX#: o r I O DOO 1 Q cr LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: 5. Z tj r he . TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET J11 QO M 4g-fA �j-�` W4 ,Sos-Z' CITY �` /4� STATE ZIP OWNER PHONE: CQ 06) 5S 7 '2o A'f1 OWNER EMAIL: 5e er (J j N 1 i1-e �ri' rA31. CONTRACTOR NAME: 014444— CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ca a 6) 0`t,{ -- — 350 3 J()h,1.1 yeA CONTACT EMAIL: J O It h re,,y264(-4.7 II—. GC.,..7N BUILDING PERMIT APPLICATION Existing Use of Building: 5 )1.li-,L' tIt Or 147--ss /1:> 1(- ? Contract Price of Work: $ � t 000 -' Proposed Use of Building: 511J- E-. ._ Iv-r )7ith--- Heat Source: ❑Gas RE teethe ❑Other Building Type: ❑SFR-Detached ° SFR-Attached ❑Duplex El Multi-Family--#of Units: ❑Commercial ❑Industrial Type of Project: ❑New ❑Addition riaRemodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ODemolition OChange of Use DESCRIPTION OF WORK: r...71).( (-t_rN2ti 0b` /3;1,'2,1 ix 7-,41.,;;;..c i Nei -141A-S7 f1174:5di- V 134-44- 4 (c--i' J 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 /IF Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Boiler Z. Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration I Shower Floor Drain Gas Fireplace Wood Stove ( Kitchen Sink&Disposal Grease Trap Gas Range Ducting ( Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: 3 Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: SPRINKLER I SUPPRESSION SYSTEM Chemical or Water I 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 1 PERMIT# Owner/AuthgraerAgent Signature / Date (Revised 9/23/2016)