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PERMIT APPLICATIO <br /> 4-77- 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 I (E)everetteps@everettwa gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2364--//2- Cr SE (Unit 3A') PROPERTY TAX#: 005757001 01902, <br /> ,IQ5757n0101a03 <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 /> crni Tarzana STATE CA ZIP 91356 <br /> OWNER PHONE: 818-822-6560 OWNER EMAIL: gnioalem@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: ElOWNER ❑ CONTRACTOR 0 OTHER(Please Specify) Architect <br /> CONTACT NAME: Peter Anderson CONTACT PHONE: 206-949-5828 <br /> CONTACT EMAIL: pga.imagodelineo@msn.ccm <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Vacant property Contract Price of Work: $ 100.000 <br /> Proposed Use of Building: TownhollrP Heat Source: EGas GElectric DOther <br /> Building Type: ❑SFR-Detached DSFR-Attached ❑Duplex DMulti-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ESprinkler El 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 /> Fixtur s Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems '' i Unit Heater 2 Bathtub Urinal <br /> Gas Piping Boiler 5 Lavatory(Wash Basin) Drinking Fountain <br /> I Water Heater Refrigeration 1 Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink& Disposal Grease Trap Range Ducting <br /> 1 Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: i Clothes Washer Medical Gas <br /> Range Hood <br /> Water Heater Other <br /> I Exhaust Fan 1 Sink(Service/Bar/Mop/etc.) Other <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> 'Chemical or Water I 'No. of Heads <br /> ACKNOWLEDGEMENT:l 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 /> .I��`\ �� 7./ D / PEFfy11T# BOO ',lib <br /> �, <br /> • 11\ 1\.:/' <br /> Owner/Authorized Agent Signature Date <br /> (Revised 9/23/2016) <br />