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.—t 1►y <br /> (4.7. PERMIT APPLICATION <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:717 89TH 104 ST SE PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:DONALD BALLARD TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET717 89TH AVE ST SE <br /> ciTY EVERETT STATE WA zip 98208 <br /> OWNER PHONE:425 353 9312 OWNER EMAIL: <br /> CONTRACTOR NAME: MM COMFORT SYSTEMS <br /> CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE, C-200 <br /> cim' REDMOND STATE WA zip 98052 <br /> CONTRACTOR PHONE:425-881-7920 CONTRACTOR EMAIL:PERMITS@MMCOMFORTSYSTEMS.COM <br /> CONTRACTOR LICENSE#(REQUIRED):MMCOMCS85564 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 055245 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-881-7920 <br /> J E NAH BARLOW CONTACT EMAIL:PERMITS©MMCOMFORTSYSTEMS.COM <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $ 0r-C, <br /> Proposed Use of Building: Heat Source: ❑Gas f1Electric ❑Other <br /> Building Type: ESFR-Detached ❑SFR-Attached ODuplex ❑Multi-Family-#of Units: OCommercial ❑Industrial <br /> Type of Project: ❑New DAddition ❑Remodel D,Repair ❑T.I. OSign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> ho t pA y) C\i y (AX <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 i 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 /> 'Number 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PER. IT# <br /> Owiner/Authorized Agent Signature Date (Revised 10/12/2015) <br />