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PERMIT APPLICATIC= .. <br /> /IP/401/* <br /> BUILDIN MECHANICAL/PLUMBING /SIGi4 UPRINKLER/ DEMOLITION <br /> a 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 /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3222 MUKILTEO BLVD, EVERETT, WA 98203 PROPERTY TAX#: 00571700102100 <br /> LEGAL for new construction: Short Plat/subdivision SHORE ACRES ADD SLK 001 D-00 Lot No. 21 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: DONNA HARTMAN TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3222 MUKILTEO BLVD <br /> cITY EVERETT STATE WA ZIP 98203 <br /> OWNER PHONE: (206)790-2126 OWNER EMAIL: delenga@comcast.net <br /> CONTRACTOR NAME: MANOS CONSTRUCTION INC. <br /> CONTRACTOR ADDRESS: STREET 1422 EAST ALOHA STREET <br /> CITY SEATTLE STATE WA ZIP 98112 <br /> CONTRACTOR PHONE: (206)617-0961 CONTRACTOR EMAIL: jon.p.manos@gmail.com Ji 600 12 <br /> CONTRACTOR LICENSE#(REQUIRED): #MANOSCI144PA CITY OF EVERETT BUSINESS LICENSE#(RE a IRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR OTHER(Please Specify) ARCHITECT <br /> CONTACT NAME: CONTACT PHONE: (206) 919-9497 <br /> DAVID LITZLER (LITZLER STUDIOS LLC) CONTACT EMAIL: DAVID@LITZLERSTUDIOS.COM <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:SINGLE-FAMILY RESIDENCE Contract Price of Work:$29@0'— WI 000* <br /> Proposed Use of Building: SINGLE-FAMILY RESIDENCE Heat Source: ❑Gas ❑Electric ❑Other N/A <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: New Addition ❑Remodel ❑Repair ❑T.I. 13 Sign ❑Sprinkler ❑Demolition El Change of Use <br /> DESCRIPTION OF WORK: <br /> PERGOLA ADDITION TO EXISTING DECK <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 #of List of Fixtures List of Fixtures #of List of Fixtures #°f List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> NC–Air Handling Units 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 /> Chemical or Water ' 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.lam 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 of Everett Official Use Only <br /> I PERMIV cifkl <br /> 0 /Authorized Agent Sig -ture Da (Revised 9/23/2016) <br />