Laserfiche WebLink
EVERETT <br />iNdSW INMTON <br />• i <br />PERMIT APPLICATION <br />BUILDING / MECHANICAL i PLUMBING i SIGN i 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:3614 Friday Ave <br />I PROPERTY TAX #:00451500700900 <br />LEGAL for new construction: Short Plat/subdivision <br />Lot No (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Jordan Pellett <br />TENANT BUSINESS NAME {Commercial): <br />OWNER MAILING ADDRESS: STREET3614 Friday Ave <br />c,n Everett <br />STATE WA <br />zip 98201 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: N/A <br />CONTRACTOR ADDRESS: ,STREET <br />CITY <br />STATE <br />CONTRACTOR PHONE: <br />CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): <br />I CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: EI OWNER [I CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />JORDAN PELLETT <br />CONTACT PHONE: 425-289-9335 <br />CONTACT EMAIL:,JORDAN@SITE42.COM <br />BUILDING INFORMATION <br />Existing Use of Buildin :SINGLE FAMILY RESIDENTIAL <br />Contract <br />Price of Work:1 <br />Proposed Use of Buildin ;SINGLE FAMILY RESIDENTIAL <br />Heat Source: i]Gas ❑Electric ❑Other <br />BUILDING USE: ❑SFR ❑Townhouse ❑Du lex ❑ADU ❑Multi -Family - # Units: OCommerciai <br />DAccessory Structure <br />Type of Project: ❑New ✓❑Addition ❑Remodel ❑Repair <br />❑T.I. []Sign ❑Sprinkler, ❑Demolition <br />[]Change of Use <br />DESCRIPTION OF WORK: INSTALLATION OF GAS FURNACE AND AC <br />ASSOCIATED BUILDING PERMIT # if applicable): <br />MECHANICAL <br />PERMIT APPLICATION <br />PLUMBING PERMIT 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 />List of Fixtures <br />1 <br />AIC — 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 Ventilatior <br />(Not Heat/AC system) <br />lFloor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />1 <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplacelinsert/Log <br />Roof Drains <br />I <br />lWater Heater <br />SPRINKLER 1 SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Watcpr oppression System <br />Na. of Heads <br />Chemical suppmission System, <br />No, of Heads <br />- - - -_ <br />ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and correct. Work dome 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 frorn the <br />Building Official before being authorized under any circumstance i am the owner, or am authorized by the owner of this property it) perform the work for which application is made, <br />and t crgnp; Vitt; tf'State Contractors Law 162 iZC w d 296_200A ir3iAC. <br />City of Everett Official Use Only <br />n <br />r t PERNII 6-Cj <br />TertAuthorizecl Agent Siginature t'Satrs (Revised 1011W018) <br />i>'y <br />