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III PERMIT APPLICATION. <br /> �� BUILDING1MECHANICAL/ 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 /> Glue.,or:Black,°Ink.OnlyPlease)' PROJECT SITE INFORMATION. ,:; <br /> Q 00575700101902, <br /> PROJECT SITE ADDRESS: <br /> Z O -112. i( $C PROPERTY TAX#: 00,7570010190:3 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> '` c, CONTACT INFORMATION <br /> OWNER NAME: MVM Development and Construction TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 19528 Ventura Boulevard, Suite 573 <br /> cry Tarzana STATE CA ZIP 91356 <br /> OWNER PHONE: 818-822-6560 OWNER EMAIL: gmoalem@gmail.com <br /> CONTRACTOR NAME: Same as above <br /> CONTRACTOR ADDRESS: STREET <br /> CITY <br /> STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): OF EVERETT BUSINESS LICENSE#(REQUIRED. �q' S <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 51 OTHER(Please Specify) Architect <br /> CONTACT NAME: Peter Anderson CONTACT PHONE: 206-949-5828 <br /> CONTACT EMAIL: pga.imagodelineo@msn.com <br /> =BUILDING:PERMIT APPLICATION. <br /> Existing Use of Building: Vacant property Contract Price of Work:$ 100,000 <br /> Proposed Use of Building: Townhouse Heat Source: ❑Gas IDIElectric DOther <br /> Building Type: ❑SFR-Detached EISFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New DAddition ❑Remodel ❑Repair DTI. ❑Sign ❑Sprinkler ❑Demolition OChange 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 <br /> Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures <br /> A/C—Air Handling Units I Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems y 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 Water Heater Other: <br /> 2 Exhaust Fan 1 Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I 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.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and/corn,with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> air PER`., Iv.4 •. 01 <br /> uthp <br /> Owner/Au orized Agent Signature Date (Revised 9/23/2016) <br />