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4 I
<br /> PERMIT APPLICATION
<br /> BUILDING / MECHANICAL/ PLUMBING / SIGN / SPRINKLER / DEMOLITION
<br /> 01;
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> �/C�ll 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 vnnw.everettwa.gov/permits
<br /> (Blas Or Bllack ink Only PRf JEICT SITE INFORMATION
<br /> PROJECT SITE ADDRESS: 6517 Elliott Way St PROPERTY TAX#: 00392901101300
<br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)
<br /> CONTACT INFORMATION W////7' .e.,
<br /> OWNER NAME: Leona Mann TENANT BUSINESS NAME(Commercial):
<br /> OWNER MAILING ADDRESS: STREET 6517 Elliott Way SE
<br /> CITY Everett STATE WA ZIP 98203
<br /> OWNER PHONE: 610 864 1614 OWNER EMAIL: Mann400@msn.com
<br /> CONTRACTOR NAME: Sound Seismic LLC
<br /> CONTRACTOR ADDRESS: STREET 7543 15th Avenue NW
<br /> CITY Seattle STATE WA ZIP 98117
<br /> CONTRACTOR PHONE: 206 352 5644 CONTRACTOR EMAIL: preproduction @soundseismic. e. 4
<br /> CONTRACTOR LICENSE#(REQUIRED): SOUNDSL836ND CITY OF EVERETT BUSINESS LICENSE#(REQUI-,-I):
<br /> PRIMARY CONTACT: ❑OWNER )`.3 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 206 352 5644
<br /> John Crowell
<br /> CONTACT EMAIL: preproduction@soundseismic.com
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<br /> Existing Use of Building: SFR Contract Price of Work: $ 9,810.16
<br /> Proposed Use of Building: Heat Source: ®Gas DElectric DOther
<br /> BUILDING USE: Ig1SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure
<br /> Type of Project: New ❑Addition ❑Remodel Repair T.I.❑ ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use
<br /> DESCRIPTION OF WORK:
<br /> Seismic retrofit to crawlspace of SFR
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> .MECHANICAL PEooT4 * %%i/,,,,s,„ „ PLUMBING-PERMIT AMM�' '�'�I:*��//�%%////%%%%/�',,,,
<br /> Fixture Fixture 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 /> iii
<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 /> ' i
<br /> Exhaust Fans(Residential) Commercial Ventilatio 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/InserULog Roof Drains Water Heater
<br /> ,{,�,p i —ice
<br /> /�/,:,7- �,,r . t ,,,� "7 `�, ;, """' Sewage Ejector or Sump Pump Other:
<br /> Water Suppression System No.of Heads
<br /> Chemical Suppression System I No.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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC.
<br /> City Everett Official Use Only
<br /> /S/John Crowell 4/23/2019 PER (9 0(4 _ 0 3 3
<br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018)
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