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• PERMIT APPLICATION• <br /> 12 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:717 Locust St PROPERTY TAX#:0045920100000 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> , CONTACT INFORMATION <br /> OWNER NAME: Housing Authority of Everett TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: SEEETPO Box 1547 <br /> c,TM Everett STATE WA zip 98206-1547 <br /> OWNER PHONE:425 3031162 OWNER EMAIL:katrinat@.eVha.Org <br /> CONTRACTOR NAME:RJ Painting <br /> CONTRACTOR ADDRESS: sTSEETPo Box 1601 <br /> cmr Sultan STATE WA zip 98294 <br /> CONTRACTOR PHONE:425-210-9394 CONTRACTOR EMAIL:r).painting@aol.com <br /> CONTRACTOR LICENSE#(REQUIRED):RJPAI**044CM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 052396 <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-210-9394 <br /> John Williams CONTACT EMAIL:rj.painting@aol.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Multi-Family Resident Contract Price of Work:g39,745.64+Tax <br /> Proposed Use of Building: Heat Source: ['Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR OTownhouse ❑Duplex ❑ADU iZIMulti-Family-#Units:4 OCommercial OAccessory Structure <br /> Type of Project: ONew OAddition ❑Remodel I21Repair OT.I. OSign OSprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF WORK: Repair small fire damages-Smoke seal attic and interior. Replace removed insulation, <br /> Replace remove GWB in 12x9 bd. rm. (2 layer 1/2"ceiling)(1/2"'walls),replace ceiling in bath rm. 2 layer 1/2"GWB. <br /> Replace 2 broken windows. Repaint Full interior, replace flooring in affected areas <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures team List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-camp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other. Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/nsert/Log Roof Drains Water Heater <br /> SPRINKLER!SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other. <br /> Water Suppression System I 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 Official before being authorized under any circumstance.1 am the owner,or I am authorized by the owner of this properly to perform the work for which application is made, <br /> and I co ply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of EveretttOOff(Dficial Use Only <br /> 41 <br /> PERMI D(J\/ V � <br /> Owne thorized Agent Signature /30/Jo <br /> Date (Revised 10/10/2018) <br /> -2 5- 003 <br />