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PERMIT APPLICATIC <br /> 471fiTBUILDING / 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 l (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 22Z 6 //2 f*C C ' ') PROPERTY TAX#: 005757001 01902. <br /> f%0.5757(?(li 0191M- <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 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): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER (Please Specify) Architect <br /> CONTACT NAME: njerso.n CONTACT PHONE: 206-949-5828 <br /> p`,y: , <br /> CONTACT EMAIL: pga.imagodelineo@msn,Com \ <br /> BUILDING PERMIT APPLICATION / <br /> (\C <br /> Existing Use of Building: Vacant property Contract Price of Work: $ 1 .000' �.'2 '" 2_512. - do <br /> Proposed Use of Building: Town housP Heat Source: ❑GasL�Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial El Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel El Repair DTI. ❑Sign ❑Sprinkler ❑Demolitio' ❑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 /> Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Q Heat Pump 4, Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems 'f,, Unit Heater _ 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 /> Clothes Dryer Hookups Other: 1 Clothes Washer Medical Gas <br /> Range Hood X Water Heater Other: <br /> 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 /> .'y <br /> i;fiu. ,_,,x.,......._, <br /> PERT!! <br /> Owner/Au horized Agent Signature Date (Revised 9/23/2016) <br />