810 90TH ST SW 2019-08-14 - Laserfiche WebLink

, PERMIT APPLICATION / ''�-.4 BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION 011‘' CITY OF EVERETT PERMIT SERVICES ORIGINAL 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 _.. ` ,r t#R Ett,IT.E'INFORMATION :F PROJECT SITE ADDRESS:11 Q co-w)1/4.1_<k) PROPERTY TAX#:7.(J j60 IA\ D2(7Z o LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) r phN I VI,,, Hli ��MITCA TACT INFORMATION „ ?gid l" yx i ' ' OWNER NAME: Lal,JrtX Ob/61 e1 a ROT/ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET fQ 40 3- 3(A.) CITY FVe Vet- STATE Vv ZIP geZai OWNER PHONE: 9,2-6-_-74o- q&-z. OWNER EMAIL: Li i fd1\a�jy�o_copy-) 6666 mow CONTRACTOR NAME: 3o) Flan-e, CONTRACTOR ADDRESS: STREET 1\16 'Z2 n' 3t.� #l CITY MOW-10p_ Tief var? STATE(4), A- ZIP ggil i/IT CONTRACTOR PHONE: I-- 7 `— 1 —7 � CONTRACTOR EMAIL: 1 n-I(J . ' ief-Mini 1 (df/I CONTRACTOR LICENSE#(REQUIRED):13 Ai EF9+ 1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):057-7G/O PRIMARY CONTACT: 0 OWNER -CONTRACTOR 0 OTHER(Please Specify) CON CT NAME:/ CONTACT PHONE: 11-25--: 71 -7 q Onnem \..\_. CONTACT EMAIL: info 1/ eimer(1,24/0--,:r0),72 -15 E=�,J v a -. �' Y ri :7h i16R ixo Nr �. 'i „:.. �. �`?�n5 d(r! �'k .� , i �, = t;r. ',s.. BU#L4i rt"tt Ii 'PPCA A*IO .w ,4 r t € r,n ° L r . ._ P Existing Use of Building: Contract Price of Work:$.... .15-1(1/30 Proposed Use of Building: Heat Source: 'as ❑Electric ❑Other Building Type: 4g-41-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: El New ddition ❑Remodel ❑Repair ❑T.I. ❑Sign El Sprinkler ❑Demolition ❑Chan a of Use DESCRIPTION OF WORK: , ion S ` tonL) ie _ l a ( � �r�' �c�cf�,t�k e -tatn 7-- gO5 TRATiaees Ond . __ air caythi-ovievs. ASSOCIATED BUILDING PERMIT#(if applicable): C �" a74 P IT.APP ` A "5I��"I' i!C FII 11111�r�yh iri'N�i to : T,, s .;; i. 11�iY'. �MI~.aNI�+ 41�L•, .S,�M i� L�t:%►Tlta��,_. ��:�I�Itli�:r �.�;66IIIVVI��hn�" ,�,Vllu�a�i°-; P„K.UMBINR� PERM�T dr?!i��IC�A'I'ION'='; .d7�$� irlal��l��,” 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 Toilet Backflow Preventer(Inside Bldg) A Forced Air Systems Unit Heater Bathtub Urinal Gas Piping Liolt S Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration Shower Floor Drain Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap Gas Range I Ducting / Dishwasher Roof Drains Clothes Dryer Hookups Other: Clothes Washer Medical Gas Range Hood Water Heater Other: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: 2S'SPRINKL01I SUPPRESSION'SYSTE. „1::::1:1, Number 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.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made, and I comply with the S,to Contractors -w 18.27 RCW and 296.200A WAC. / City of Everett Official Use Only / I �l PERMIT i , _ - ii - O�3118 � � � g 'ir e'irut";ri ed A.e. Signa ure /,/°'. Date (Revised 10/12/2015)