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N PERMIT APPLICATIM <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / 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: �f . z? �' ?(( <br />PROPERTY TAX #: 00612000001602 <br />LEGAL for new construction: Short Plat/subdivision Lot No (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Anthony Iazeolla TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: STREET 17310-107Ave SE <br />ciTv Snohomih STATE WA zip 98296 <br />OWNER PHONE: 425-754-3300 <br />OWNER EMAIL: tonyi@first-phase.net <br />CONTRACTOR NAME: First Phase Construction, Inc <br />CONTRACTOR ADDRESS: STREET 17310-107 Ave SE <br />c,TY Snohomish STATE WA zip 98296 <br />CONTRACTOR PHONE: 425-754-3300 <br />1 CONTRACTOR EMAIL: same as above <br />CONTRACTOR LICENSE #(REQUIRED): ccflrstpc988Cm <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIR ) <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Tony Iazeolla <br />CONTACT PHONE: 425-754-3300 <br />CONTACT EMAIL: tonyi@first-phase.net <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Vacant <br />Contract Price of Work: $ 149,000 <br />Proposed Use of Building: Resldental <br />I Heat Source: ❑Gas OElectric ❑Other <br />Building Type: OSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi -Family-# of Units: ❑Commercial [Industrial <br />Type of Project: ONew ❑Addition ❑Remodel ❑Repair ❑T.I. []Sign []Sprinkler ❑Demolition []Change of Use <br />DESCRIPTION OF WORK: <br />New SFR Residental _ <br />ASSOCIATED BUILDING PERMIT # (if applicable): ''� Zvi 2V � - � � � � U <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _ Addn _Alteration _Repair <br />Type of Project: New _Addn _Alteration _Repair <br />Fixtures <br />List of Fixtures <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C - Air Handling Units <br />Heat Pump <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />1 <br />Forced Air Systems <br />1 <br />Unit Heater <br />Bathtub <br />1 <br />Urinal <br />Gas Piping <br />1 <br />Boiler <br />Lavatory (Wash Basin) <br />1 <br />Drinking Fountain <br />1 <br />Water Heater <br />1 <br />Refrigeration <br />1 <br />Shower <br />1 <br />Floor Drain <br />1 <br />Gas Fireplace <br />1 <br />Wood Stove <br />Kitchen Sink & Disposal <br />1 <br />Grease Trap <br />1 <br />Gas Range <br />1 <br />Ducting <br />Dishwasher <br />1 <br />Roof Drains <br />1 <br />Clothes Dryer Hookups <br />1 <br />Other: <br />1 <br />Clothes Washer <br />1 <br />Medical Gas <br />1 <br />Range Hood <br />1 <br />1 <br />Water Heater <br />1 <br />Other: <br />1 <br />Exhaust Fan <br />1 <br />Sink (Service/Bar/Mop/etc.) <br />1 <br />Other: <br />1 <br />1 <br />SPRINKLER <br />/ SUPPRESSION <br />SYSTEM <br />1 <br />1 <br />Chemical or Water 1 <br />1 <br />1No. 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 />Paul ThompsonP <br />Owner/Authorized Agent Signature <br />oalti�112��� <br />City of Everett Official Use Only <br />PERMIT <br />(Revised 9/23/2016) <br />