11201 3RD AVE SE 2019-08-13 - Laserfiche WebLink

PERMIT APPLICATION- A#111P'/400r/-"--4 BUILDINECHANICAL!PLUMBING 1 SCG RINKLER 1 DEMOLITION *4i CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: 11201 3rel hv1`JEI#'4oG &/GreJL wA 98300 PROPERTY TAX#:0070(020`-4 000 ZOO LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:60000+ +'Sae (yn cire.�') (y W TENANT BUSINESS NAME(Co. rnerciL b OWNER MAILING ADDRESS: STREET 11201 113rd Ave 3E #y08 Q /� / crry Ever&44- STATE (AJ ZIP(461Z08 / OWNER PHONE: (021.0 -Z(o0- 3g52. OWNER EMAIL: Corbem-andjrt oneonr; • Cly 1>7 CONTRACTOR NAME: ArAVan\--M-e, Cb t1 rCkc l-bre- I r r. CONTRACTOR ADDRESS: STREET y 2SO1 ict<-Fora Aue.. '�I o 0 17r 844-1 aZ CITY Sno\1nn'1( -or ' STATE tAjil ZIP 9VZ /o CONTRACTOR PHONE: L ZS- 330 - Qq Q5 CONTRACTORyEMAIL:+(�,rni 8 to ad a n1- ,8dr-trade,r .cc,'')') CONTRACTOR LICENSE#(REQUIRED): Apt/A M C1 '103 1/ 1 CITY OF EVERETT BUSINESS LICENSE#(WEQUIRED):0q 33 -7' PRIMARY CONTACT: gOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (o7(D _2400 , 3q5-2 efx‘564 curl j him CONTACT EMAIL: eiyi)-e4+ayldietton(43t )ai 1. API BUILDING INFORMATION k 1. 1 poo Existing Use of Building: Contract Price of Work:$ 1 4! Proposed Use of Building: C,Ond,Q orea Heat Source: ❑Gas Electric DOther BUILDING USE: DSFR ❑Townhouse ❑Duplex ❑ADU Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ❑Remodel Repair DTA. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: fem ov , and replace decd C Icor"Ina -- 14 00 S F >G 25 ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixturetexture Fixture Fixture Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures NC—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 Ventilatior 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 I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other. Water Suppression System No.of Heads Chemical Suppression System No.of Heads ACKNOWLEDGEMENT:t 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.tam the owner,or!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 04rditrn C DIAA" lift\ 1 Ici psk#ct 0(4 .... c) ,-4.._ Owner/Authorized Agent Signature Date (Revised 10/10/2018) 1'