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107Err PERMIT APPLICATION <br /> 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 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 10811 1ST DR SE, Everett, WA. 98208 PROPERTY TAX#: 00391500004800 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Dania) Johnson TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 10811 1st Dr. SE <br /> CITY Everett STATE WA ZIP 98208 <br /> OWNER PHONE: 425-232-8121 OWNER EMAIL: danialpjohnSOrl@yahoo.COm <br /> CONTRACTOR NAME: PE Construction, Clyde Porter <br /> CONTRACTOR ADDRESS: STREET 13329- 226th Ave NE <br /> CITY Granite Falls STATE WA ZIP 98252 <br /> CONTRACTOR PHONE: 360-691-1600 CONTRACTOR EMAIL: cwporter©porterent.comcastbiz.net <br /> f.A. <br /> CONTRACTOR LICENSE#(REQUIRED): CC PECONC*833QZ CITY OF EVERETT BUSINESS LICENSE# I .. 11 /_• <br /> PRIMARY CONTACT: 0 OWNER V CONTRACTOR 0 OTHER(Please Specify) 1'^ <br /> CONTACT NAME: CONTACT PHONE: 360-691-1600 <br /> Clyde Porter CONTACT EMAIL: cwporter©porterent.comcastbiz.net <br /> BUILDING PERMIT APPLICATIO /� <br /> Existing Use of Building:SFR Contract Price of Work:$60,000 <br /> Proposed Use of Building: SFR Heat Source: Gas PIElectric ❑Other <br /> Building Type: I7ISFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#oflUnits: ❑commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition Remodel 0 Repair DTA. ❑Sign ❑Sprinkler --❑Derf-olition ❑Change of Use <br /> DESCRIPTION OF WORK: i, Cc.A‘ ;- %L,.'%L` K,s,;-ekctHi CPJ. " \ , P,Ae►.k Z 0 .AA <br /> P._L1 th1Z \---L-` '�J 4 R0v"\e 1I`\L\ <br /> APP 2S S,F. g-iJrie-y 47 A,-ig-A.Gg-7441e-c_..a, 4y <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 1 Alteration , Repair <br /> #of II of #of #of <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater i Bathtub Urinal <br /> Gas Piping Boiler y Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration j Shower Floor Drain <br /> Gas Fireplace Wood Stove 1 Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting , Dishwasher Roof Drains <br /> ( Clothes Dryer Hookups Other: t Clothes Washer Medical Gas <br /> 1 Range Hood t 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. 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 Contr ctors Law 18.27 RCW and 296.2004 WAC. <br /> City of Everett Official Use Only <br /> d <br /> j - PERMIT <br /> k �~JJ <br /> `O <br /> ��� 1t� <br /> i <br /> Owner/ uth z Agent ignature Date (Revised 9 /2016 <br /> j.) <br />