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IIIIII '' PERMIT APPLICATIC <br /> �/— BUILDINb7MECHANICAL / PLUMBING / SIGN / SPRINKLER/ DEMOLITION <br /> Imo' 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: 2 2 2 2 • //2`' /r /c96""e 5 / (-L" ) PROPERTY TAX#: 07VC1 01901, <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 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): MIVNIL .1CITY OF EVERETT BUSINESS LICENSE#(REQUIR � 3 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Architect <br /> CONTACT NAME: Peter Anderson CONTACT PHONE: 706-949-5828 <br /> CONTACT EMAIL: pga.imagodelineo@msn.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Vacant property Contract Price of Work: $ 1 00.000 <br /> Proposed Use of Building: Townhouse Heat Source: ❑Gas 0-Electric DOther <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: 0 Commercial 0 Industrial <br /> Type of Project: ❑New DAddition ❑Remodel ❑Repair ❑T.I. ❑Sign DSprinkler ❑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: 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 /> Fixture Fixtures Fixtures <br /> A/C-Air Handling Units Heat Pump 4 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater 2 Bathtub Urinal <br /> Gas Piping Boiler 5 Lavatory(WashBasin)1 Drinking Fountain <br /> Water Heater <br /> Refrigeration _ 1 Shower Floor Drain <br /> Gas Fireplace Wood Stove 1 Kitchen Sink& Disposal Grease Trap Range Ducting <br /> _ 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 JNo. 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 l 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 /> ...Y4e� City of Everett Official Use Only <br /> I Mt 1./a. /7 IP.. ._MI(1.-4.04 ._0 ( t <br /> Owner/Authorized Agent Signature Date <br /> (Revised 9/23/2016) <br />