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10508 29TH AVE SE 2019-08-08
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10508 29TH AVE SE 2019-08-08
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Last modified
8/8/2019 10:44:35 AM
Creation date
8/8/2019 10:44:35 AM
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Address Document
Street Name
29TH AVE SE
Street Number
10508
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NMI <br /> PERMIT APPLICATION■ <br /> BUILDING/ MECHANICAL/PLUMBING/SIGN /SPRINKLER i DEMOLITION <br /> EVERETTCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: JO C$ PROPERTY TAX#: ©68-.5,2,,7® C3 e-, <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: —775,4)r I,,0>4/i7a4iJ TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET hAn—Z9�' .;L „iv <br /> 4� <br /> CITY di—:;-7,-"k-e >G - STATE D._- ZIP 9 424 T- <br /> OWNER PHONE: _ ..2/g--,..63 / OWNER EMAIL: <br /> CONTRACTOR NAME: � /01.41e- <br /> CONTRACTOR <br /> 1.41e CONTRACTOR ADDRESS: STREET 7 k> <br /> CITYk.,,Z._xJt!=AP,Aji STATE ZIP 9 <br /> CONTRACTOR PHONE: CONTRACTOR j��,� -79 CONTRACTOR EMAIL: J, i4 2 At rG,� <br /> CONTRACTOR LICENSE#(REQUIRED):,/,44/Z ®/N9 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):6 O 9 <br /> PRIMARY CONTACT: ❑OWNER ZKONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAM,E:: 1� � � CONTACT <br /> PHONE: k'9_f0re- <br /> BUILDING INFORMATION l <br /> Existing Use of Building: Contract Price of Work:$ .1 <br /> Proposed Use of Building: Heat Source: iiirZas DElectric ❑Other <br /> BUILDING USE: ,.P"'.FR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family #Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel 8kepair DTA. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> 6/42 4 4v 2 / 7s .s ' . re ,.441 1'1C>:ADf, <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Court List of Fixtures Count List of Fixtures Count List of Fixtures <br /> i' A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log I FORA 4 . Roof Drains Water Heater <br /> SPRINKLER/;SUPPRESSION SYSTEM - Sewage Ejector or Sump Pump Other: <br /> Water Suppression System I No.of Heads <br /> Chemical Suppression System 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.I am 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 /> PERMIT#`1 \ <br /> /JI oT 1 <br /> 0 Authorize Agent S'• riff" Date (Revised 10/10/2018) (/ <br />
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