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0 PERMIT APPLICATION 11111 <br /> Ell <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: 4735 Glenhaven Dr Everett, WA 98203 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Dutton Michael E TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: sTREET4735 Glenhaven Dr <br /> ciTr Everett STATE WA ZIP 98203-1740 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:NOrth Creek Contractors Inc <br /> CONTRACTOR ADDRESS: sTREET13110 NE 177th pl Suite 396 <br /> ,,Ty Woodinville STATE WA ZIP 98072 <br /> CONTRACTOR PHONE:425-518-4233 CONTRACTOR EMAIL:Kris@northcreekcontractors.com <br /> CONTRACTOR LICENSE#(REQUIRED):NORTHCC859R8 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED ' 'J17 (/)l9D <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) (00 2 6(0-1 6 S L <br /> CONTACT NAME: CONTACT PHONE:425-518-4233 <br /> Kris Jones CONTACT EMAIL:Kris©northcreekcontractors.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:SFR Contract Price of Work:$ g000• e� <br /> Proposed Use of Building:SFR Heat Source: EGas ❑Electric ❑Other <br /> BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: New ❑Addition ❑✓Remodel ❑ epair LIT.I. ElSign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: S-r it4s t Ii_ti{G ".3 - �-{ �J+�-3 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): B1911-017 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) 3 Shower,Tub,or Combo <br /> Boiler % Gas Range ! Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer * Heat Pump&Ductless Dishwasher 9. 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 /> I 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/Insert/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:1 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 i 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 a th�rized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, <br /> and i corn e o t ctors Law 18.27 RCW and 296.200A WAC. <br /> L City of Everett Official Use Only <br /> PERMIT# <br /> Owner/Authorized Agent Sign ure Date (Revised 1 /10/2018) <br />