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PERMIT APPLICATION <br /> Oren- BUILDING I lrr�cCHANICAL / PLUMBING / SIGN /!IINKLER/ 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: JC;Unit 13D PROPERTY TAX#: 005757001 0 1 902, <br /> f3o5757nf1101903 <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 <br /> ZIP o 1356 <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: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):SS 95 3, <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR 0 OTHER (Please Specify) Architect <br /> f <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: $ 1 00.00.0 <br /> Proposed Use of Building: Townhouse Heat Source: DGas CElectric ❑Other <br /> Building Type: DSFR-Detached ❑SFR-Attached ❑Duplex DMulti-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ONew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign DSprinkler ODemolition DChange 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 <br /> Fixtures List of Fixtures List of Fixtures List of Fixtures #of <br /> Fixt res Fixtures Fixtures List of Fixtures <br /> A/C–Air Handling Units Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems ',,b7 Unit Heater 2 Bathtub Urinal <br /> Gas Piping Boiler 5 Lavatory(Wash Basin) Drinking Fountain <br /> ? Water Heater Refrigeration 1 Shower <br /> Floor Drain <br /> Gas Fireplace Wood Stove 1, Kitchen Sink& Disposal Grease Trap•Range Ducting <br /> Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: l Clothes Washer Medical Gas <br /> Range Hood `i'.,j Water Heater Other: <br /> Exhaust Fan 1 Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> 'Chemical or Water I INo. 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 Stat ontractors Law�18.27 RCW and 296.200A WAC. <br /> �, City of Everett Official Use On/y <br /> 1 1,7 <br /> �- 4., <br /> I <br /> PERMIT, I i� i ' X11 i ( � 02-0 <br /> Owner/Authorize• Agent Signature Date ` J <br /> (Revised 9/23/2016) <br />