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" II'' II'' <br /> PERMIT APPLICATIO <br /> BUILDINt�T IECHANICAL/ PLUMBING/SIGN 1 SPRINKLER/DEMOLITION <br /> EVERETT E R E T T CITY OF EVERETT PERMIT SERVICES <br /> c Y G 1 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:5008 Nichols Place, Everett, WA 98203 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Brett and Jennifer Altmyer TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET5008 Nichols Place <br /> Everett STATE WA ZIP 98203 <br /> OWNER PHONE: Z.S- cl ii- pi? OWNER EMAIL: Alm Ufel--ehf7�'14//, eafri <br /> CONTRACTOR NAME:Country Carpenter LLC <br /> CONTRACTOR ADDRESS: STREET 2 qz 9 Z.-arch a/y <br /> crit' Lynnwood ./ STATE WA ZIP ei8D3� <br /> CONTRACTOR PHONE:425 744 4554 CONTRACTOR EMAIL:ronniecearley@comcast.net <br /> CONTRACTOR LICENSE#(REQUIRED G O i&��C L jQ , CITY OF EVERETT BUSINESS LICENSE#(REQUIRED. CQ D c1 t <br /> PRIMARY CONTACT: 0 OWNER b •NTRA e- 0 OTHER(Please Specify) 41 iO , a • <br /> v„i1114 <br /> CONTACT NAME: CONTACT PHONE:425-922-8123 <br /> Jennifer Altmyer CONTACT EMAIL:)altmyer@hotmail.com - c_jc-i , <br /> BUILDING INFORMATION <br /> Existing Use of Building:residential single family Contract Price of Work:$34,183 <br /> Proposed Use of <br /> BBuilding:residential single family Heat Source: Deas ❑Electric DOther <br /> BUILDING USE: t2SFR DTownhouse ❑Duplex DADU CDMulti-Family-#Units: , (Commercial ❑Accessory Structure <br /> Type of Project: :New ElAddition 26emodel ❑Repair ❑T.1. OSign ❑Sprinkler L Demolition ElChange of Use <br /> DESCRIPTION OF WORK: Remove and replace outside deck railing and decking material. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> FixtureF6cture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> 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 _ Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other. <br /> Water Suppression System Ko.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 comeci.Work done pursuant to this permit must comply with <br /> current federal,state,and local taw.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.lam the owner,or!am authorized by the owner of this property to perform the work for which application is made, <br /> and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERM <br /> L/.1/1e/L/14 S—t s— �/�/�/ 1cl,C S v-024 . <br /> er/Authorized Agent Signature Date (Revised 10/10/2018) <br />