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8316 RIM DR 2019-08-08
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8316 RIM DR 2019-08-08
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8/8/2019 7:47:31 AM
Creation date
8/8/2019 7:47:30 AM
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Address Document
Street Name
RIM DR
Street Number
8316
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PERMIT APPLICATION <br /> ,#41P,, „..-gBUILDING / MECHANICAL I PLUMBING I SIGN/SPRINKLER I DEMOLITION <br /> / CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 83 14 ,R j on j? . PROPERTY TAX#: 18 osogool/02.1©t <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Vi f cx(j f�A.g 1(AK TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET g 3 16 R lWt ck <br /> CITY Emull( STATE wA- ZIP 9v G2.0 <br /> OWNER PHONE: rf OWNER EMAIL: <br /> � <br /> CONTRACTOR NAME: y i+Ot l 4 1t4 0(rj111AX <br /> CONTRACTOR ADDRESS: STREET v V MP316 R ri d z. <br /> CITY Ev„e0:f'1` STATE UV ZIP 9A 02 08 <br /> CONTRACTOR PHONE: 4l" -,g79 -9780 CONTRACTOR EMAIL: tvd LLe 9.0 is C 3 ry-t Q;I . eovn <br /> CONTRACTOR LICENSE#(REQUIRED): LV DCOC L 8 4 7 g 1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: K OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: V i° \ LU .51A.WK CONTACT PHONE: I.��S g79 97�0 <br /> CJ CONTACT EMAIL: Lvd l f e QOIS' a@ c mail • corn <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work:$ , L4 vvv- ©O li . <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: gSFR-Detached SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New tAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> /9 et el;-1-i ov, cit eK a 2:2.at-4 i -0--; <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I No.of Heads <br /> 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 <br /> 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 <br /> Building Official before being authorized under any circumstance.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> a6 2 6 ---(g PERMIT# ptaor (,Owner/Authoriz-:A.— Si.`ature Date (Revised9/23/2016) 1•I� <br />
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