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• PERMIT APPLICATION <br /> BUILDING / MECHANICAL / PLUMBING /SIGN / SPRINKLER / DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (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:1020 Hoyt Avenue PROPERTY TAX#:00385421502600 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Jordan Stephens TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 1020 Hoyt Avenue <br /> cirr Everett STATE WA ZIP 98201 <br /> OWNER PHONE: Jordan Stephens OWNER EMAIL: <br /> CONTRACTOR NAME:Unknown at thi :me. <br /> V�' <br /> CONTRACTOR ADDRESS: STREE �J <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: El OWNER ❑ CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: � 7 3rj. 3 3 7 J <br /> Jordan Stephens CONTACTEMAIL:'3-ST "r�51.(CO3 C C.S \a.., • <br /> c.Gr <br /> BUILDING INFORMATION <br /> Existing Use of Building:Residential Contract Price of Work:$Approximately 50,000.00 <br /> Proposed Use of Building:Residential Heat Source: ❑�Gas DElectric DOther <br /> BUILDING USE: EISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ONew ❑Addition ❑✓Remodel ❑Repair ❑T.I. ❑Sign OSprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Remodel of kitchen and powder room. Replacement of window with door and gaurdrail. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtuur Count List of Fixtures Count List of Fixtures <br /> C— it Handling Units Gas Piping-" Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler 1 Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer • Heat Pump&Ductless Dishwasher 2 Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) 1 Refrigeration Drinking Fountain Sink-Utility,laundry, mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain 1 Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) ;' ater Heater Interceptor-Grease Waste/Water Piping Repair <br /> 1 Exhaust Hood(Resigefitial) Wo Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systegxs Other. Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/tiisert/Log Roof Drains Water Heater <br /> SPRINKLER/ SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System '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 Offici 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 l comply ith the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> • <br /> City of Everett Official Use Only <br /> PMIT <br /> Ow r/4uthotized Age-NtSi natur Date (Revised 10/10/2018) <br />