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PERMIT APPLICATI� <br /> BUILDI6 I MECHANICAL/ PLUMBING /Cs IT <br /> / 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 l(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 330 Heather Rd., Everett, WA 98203 PROPERTY TAX#: 00584900300300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Brian and Connie Hallgarth TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 920 Grand Avenue <br /> ciTY Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425-220-8900 OWNER EMAIL: hallgarth01@msn.com <br /> CONTRACTOR NAME: D(A)ke <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR iii OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE: 360-629-3441 <br /> Tom Rochon CONTACT EMAIL: Tom@designsnw.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:Single Family Residential Contract Price of Work:$, 1 "�v_�'�,� <br /> Proposed Use of Building: Single Family Residential Heat Source: 0Gas❑Electric ❑Other <br /> Building Type: VISFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New QlAddition I2Remodel ❑Repair CIT.!. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Interior remodel within building footprint and 290 s.f.addition along west side of house,.Replacement of all alumipum frame windows with aluminum clad wood windows(U=0.30 or lower). <br /> Xu4 <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 4Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump ,3 Toilet / Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater ` Bathtub iUrinal <br /> t.''‘If 4 <br /> Gas Piping Boiler 6Lavatory{Wash Basin) <br /> l ShowerDrinking Fountain <br /> Water Heater Refrigeration ,( 2. Floor Drain <br /> Gas Fireplace Wood Stove /.---. Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting / Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: J Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> 'Chemical or Water ' INo.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 lam 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 /> Air -`""-"" PERM' <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) Ck <br />