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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN I SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> .1W1.7 J 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:6524 Tyee rd. Everett, Wa. 98203 PROPERTY TAX#:00371400001701 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Gregory Schroeder TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 6524 Tyee rd. <br /> CITY Everett STATE Wa. ZIP 98203 <br /> OWNER PHONE: 1-206-321-6279 OWNER EMAIL: gregsschroeder@icloud.com <br /> CONTRACTOR NAME: (fit,,,) 42--- — <br /> CONTRACTOR ADDRESS: STREET <br /> CRY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 121 OWNER 0 CONTRACTOR £7 OTHER(Please Specify)Les White, designer <br /> CONTACT NAME: CONTACT PHONE:425 210 2935 e <br /> CONTACT EMAIL:arc3ddesigns@comcast.net <br /> comcast.net <br /> BUILDING PERMIT APPLICATION �- �` <br /> Existing Use of Building: unocupied Contract Price of Work ePeo6 .b 0 <br /> Proposed Use of Building:rental p\.C.?( Heat Source: ❑Gas El Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR`-Attached El Duplex ❑Multi-Family-#of Units: El Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition 1-d Change of Use <br /> DESCRIPTION OF WORK: <br /> 5744 A-Cce lPt, /7 cioivv-4-:4" oattet74 <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 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 2 Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater 2 Bathtub Urinal <br /> Gas Piping Boiler 2 Lavatory(Wash Basin) Drinking Fountain <br /> Y. Water Heater Refrigeration Shower i Floor Drain <br /> Gas Fireplace Wood Stove 2 Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting 2 Dishwasher 4 Roof Drains <br /> 2 Clothes Dryer Hookups Other: 2 Clothes Washer Medical Gas <br /> 2 Range Hood 2 Water Heater Other: <br /> 2 Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number 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 /> ' lido -20 g L512016 k �c a_ 00�er/AuthodAgen na a Date j <br /> f <br />