10625 27TH DR SE 2019-09-25 - Laserfiche WebLink

Jul 18 2018 10:52AM Washington Water ters 8663757454 page PERMIT APPLICATION e.4411":"4— BUILDING l MECHANICAL 1 PLUMBING !.SIGN I SPRINKLER!DEMOLITION CITY OF EVERETT PERMIT SERVICES 1 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.govipermits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: /Oft 6 Z7 '' f.l V 5& PROPERTY TAX#: S09 7 010 t$6, r LEGAL for new construction: Short Platlsubdivision Lot No. (attach copy of long legal description) ��} ` p� !�,7/�t CONTACT INFORMATION OWNER NAME: V I i-L ft D� 14)1)I'T TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /0� l/!t Gs' 26 71142--&vi r S CITY ^ LM-r STATE /AR- (3- ZIP �O x OWNER PHONE: LIZ '(Q 1.0 `S25() OWNER EMAIL: CONTRACTOR NAME: UJA"Sri!Ni67 v/4 ' (j ii--► 12. .1-1c--0.761.45- j� 'fC c)A q'!' �j CONTRACTOR ADDRESS: STREET /115 Z it(,'Jk- 74-r( 5C — 116 OX G f CITY .i ( STATE ^ ZIP q�f(�1-J CONTRACTOR PHONE: 426_41:3_ L/g7/ CONTRACTOR EMAIL: G4 t'I� jerffC CZ 6m! mni(L� (c CONTRACTOR LICENSE#(REQUIRED): WPrEttfirklate CITY OF EVERETT aUS1NESS LICENSE#(REQUIRED): 06,9W-6:1-,- PRIMARY CONTACT: ❑OWNER 4.CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME' CONTACT PHONE: co2„ rff13--C{g 7/ i1 i Daft Ire 15 CONTACT EMAIL: tete til .iti, @ 6474-c.(oil BUILDING PERMIT APPLICATION Existing Use of Building: Contract Price of Work:$ I P1 Proposed Use of Building: Heat Source: A las ❑Electric: ❑Other Building Type: ❑SFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial Type of Project: ONew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: 4/cr, .. q fol cL . I ‘65 aia-d' & ) ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION 054.1 PLUMBING PERMIT APPLICATION ��!!�� Type of Project: New Addn _Alteration Reps Type of Project: _New Addn� ___Alteration ,_Repair 6%R:! 11 of #of #of 1 of � i' Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures A!C-Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) Forced Air Systems Unit Heater 'Bathtub Urinal Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain Water Heater Refrigeration 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: Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: • SPRINKLER I SUPPRESSION SYSTEM . [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 an rcumstance.I am the owner,or!am authorized by the owner of this property to perform the work for whlcn application is made, and I comply with the Stale Contractors Law I .2 .CW and 296.200A WAC. Gity of Everett Official Use On y It 1 / .-11,11 / l/ PE t\%OR r Oq o Own .Authorized Agent Signature Date (Revised 5/20/2016)