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0 0 <br />PERMIT APPLICATION <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:2824 Grand Ave Entire Building Roo <br />PROPERTY TAX #:01049300110100 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Nautica SOundview COndorniniurn CwnefISNANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: s,, 2907 Hewitt Ave <br />CITY Everett STATE Wa ZIP 98201- <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME:COrinlerCial Industrial Roofing <br />CONTRACTOR ADDRESS: STREET 3601 121 st street sw <br />p p <br />CITY Lynnwood STATE WA ZIP 98087 <br />CONTRACTOR PHONE:425-423-0900 <br />1CONTRACTOR EMAIL: Ian@CIR-roofing.Conl <br />CONTRACTOR LICENSE #(REQUIRED): COMMEI*205JJ ICITY <br />OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER EZ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Ian Dugan <br />CONTACT PHONE:4255-423-0900 <br />CONTACT EMAIL: Ian@CIR-roofing.com <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Condo <br />Contract Price of Work: $ 115,000 <br />Proposed Use of Building: <br />Heat Source: []Gas []Electric []Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ®Multi -Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. []Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: asten new coverboard and TPO single ply membrane over existing roof. Install new <br />perimeter metal. <br />ASSOCIATED BUILDING PERMIT # (if applicable): <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 /># of <br />Fixtures <br />List of Fixtures <br /># of <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 />Forced Air Systems <br />Unit Heater <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />Water Heater <br />Refrigeration <br />Shower <br />Floor Drain <br />Gas Fireplace <br />Wood Stove <br />JKitchen Sink & Disposal <br />Grease Trap <br />Gas Range <br />Ducting <br />IlDishwasher <br />Roof Drains <br />Clothes Dryer Hookups <br />Other: <br />lClothes Washer <br />Medical Gas <br />Range Hood <br />Water Heater <br />Other: <br />Exhaust Fan <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />SPRINKLER <br />I SUPPRESSION <br />SYSTEM <br />Chemical or Water <br />I <br />INo. 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 for which application is made, <br />and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Owner/Authorized Agent Signature <br />Z— <br />Date <br />City of Everett Official Use Only <br />PE T # <br />2� <br />(Revised 912312016) <br />