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El <br />PERMIT APPLICATIO <br />BUILDINAECHANICAL / PLUMBING / SIGN <br />PRINKLER /DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 4632 Fowler AVE Everett WA 98203 <br />PROPERTY TAX #: 290531 003001 00 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: TENANT BUSINESS NAME (Commercial): W000naven Apartment,, <br />OWNER MAILING ADDRESS: STREET 4632 Fowler AVE, Everett WA 98203 <br />CITY Everett STATE WA 71P 98203 <br />OWNER PHONE: 1 833)324-6801 <br />1OWNER EMAIL: <br />CONTRACTOR NAME: R General Construction and Remodeling LL <br />CONTRACTOR ADDRESS: STREET 10029 South Tacoma Way Suite E-7 <br />CITY Lakewood STATE wa _,P <br />CONTRACTOR PHONE: (253)961 -3535 1CONTRACTOR EMAIL: pgrlgorash grgeneral.ne) <br />CONTRACTOR LICENSE #(REQUIRED): GRGENGC95001 <br />ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 57593 <br />PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />PAVEL GRIGORASH <br />CONTACT PHONE: 253)961 -3535 <br />CONTACT EMAIL: pgrigorash 9grgeneral.net <br />BUILDING INFORMATION <br />Existing Use of Building: aparment community <br />lContract Price of Work: $ 20000 <br />Proposed Use of Building: existing apartment community <br />lHeat Source: ❑Gas ❑✓Electric []Other_ <br />BUILDING USE: ❑SFR ❑Townhouse ❑Duplex ❑ADU BMulti-Family - # Units, 12 [--]commercial ❑Accessory Structure <br />Type of Project: ❑New ❑Addition ❑Remodel BRepair ❑✓T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change ;f Use <br />DESCRIPTION OF WORK: Building E, Replacement of existing two layers asphalt shingles with new asphalt shirgles. <br />Install 7/16" OSB sheeting where needed, curent roof deck has tongue and groove 3/4" ship lap, not being removed. <br />Not modifying the pitch. Insulation will not be exposed. Estimated number of sheets to be installed 170. <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />i. ist of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />Duct System (Remodel) <br />Refrigeration <br />Drinking Fountain <br />Sink -Utility, laundry, mop <br />Exhaust Fans (Residential) <br />Commercial Ventilation <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type 11) <br />Water Heater <br />Interceptor -Grease <br />_ <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />Roof Drains <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />No. of Heads <br />Chemical Suppression System <br />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. 1 am the owner, or I am authorized by the owner of this property to perform the work f-:r which application is made, <br />and I comply with the State Contractors Law 18.27 ROW and 296.200A WAC. <br />F� If. 1? 1V goal <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />PERM T # <br />(Revised 1011012018) <br />7 <br />