Laserfiche WebLink
PERMIT APPLICATIO <br /> (414-77BUILDING i MECHANICAL / PLUMBING / SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 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: L3Z •//21''t p7 (Unit 4A ) PROPERTY TAX#: 00575700101502. <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: MVM Development and Construction TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 19528 Ventura Boulevard, Suite 573 <br /> CITY Tarzana STATE CA zip 91356 <br /> OWNER PHONE: 818-822-6560 OWNER EMAIL: gmoalem@gmail.com <br /> CONTRACTOR NAME Same as above <br /> CONTRACTOR ADDRESS: STREET <br /> CITY <br /> STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) Architect <br /> CONTACT NAME: Peter Anderson CONTACT PHONE: 206-949-5828 <br /> CONTACT EMAIL: pga.imagodelineo@msn.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Vacant property Contract Price of Work: $ 100.000 <br /> Proposed Use of Building: Townhouse Heat Source: ❑Gas CElectric ❑Other <br /> Building Type: DSFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel DRepair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Construct new three story Townhouse <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 #of #of <br /> Fixtures List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fi ures Fixtures Fixtures <br /> A/C–Air Handling Units Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems ICUnit Heater 2 Bathtub Urinal <br /> Gas Piping Boiler 5 Lavatory (Wash Basin) Drinking Fountain <br /> 1 Water Heater Refrigeration 1 Shower Floor Drain <br /> Gas Fireplace Wood Stove 1 Kitchen Sink& Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> 1 Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood <br /> Exhaust Fan IC Water Heater Other: <br /> 2 Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Chemical or Water 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 of Everett Official Use Only <br /> Pifir <br /> P lifik4(5 <br /> + — O' O <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) I# <br />