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PERMIT APPLICATIOIF <br /> OLTBUILDING I 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 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2720g, •//2y''i act-5 (Unit 1A' PROPERTY TAX#: 00575700101902, <br /> nn5757nn1n190s <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 /> cry 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 STATE <br /> ZIP <br /> CONTRACTOR PHONE: .(O• :ACTOR EMAIL: <br /> —7' r <br /> CONTRACTOR LICENSE#(REQUI- P): f\AA k : 0 t 3 CITY OF EVERETT BUSINESS LICENSE#(REQUIRE'_ <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR U 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 <br /> Existing Use of Building: Vacant property Contract Price of Work: $ -__L0.9',/6-0 22 R- 292.00 <br /> Proposed Use of Building: Townhouse Heat Source: ❑Gas Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition El Remodel ❑Repair ❑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: x New Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repair <br /> #of #of #of #of <br /> Fixtures List of Fixtures Fixture List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixtures <br /> A/C—Air Handling Units y 1 Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit 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 1 Dishwasher Roof Drains <br /> 1 Clothes Dryer Hookups Other: 1 Clothes Washer Medical Gas <br /> 1 Range Hood 1 Water Heater Other: <br /> 2 Exhaust Fan 1 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 /> / PERMIT# <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) V <br />