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0 • <br />PERMIT APPLICATION <br />EVERETT <br />WASHINGTON <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 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:124 West Intercity avenue <br />PROPERTY TAX #:00480300600101 <br />LEGAL for new construction: Short Plat/subdivision sec 13 township 28 range 04 Lot No. 1,2,15 (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: Suzanne Darrow TENANT BUSINESS NAME (Commercial): <br />OWNER MAILING ADDRESS: s11EET124 west intercity avenue <br />c,n everett STATE WA z,P 98204 <br />OWNER PHONE: 206-697-3643 <br />OWNER EMAIL:N/i4 <br />CONTRACTOR NAME:Chanlplon windows <br />CONTRACTOR ADDRESS: STREFT19406 68th avenue south <br />CITY Kent STATE WA ZIP 98032 <br />CONTRACTOR PHONE:206-2255-2282 <br />CONTRACTOR EMAIL:bcrawford@getchampion.com <br />CONTRACTOR LICENSE #(REQUIRED):CHAM PWC008CJ <br />ICITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 389655 <br />PRIMARY CONTACT: ❑ OWNER ED CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Brenden Crawford <br />CONTACT PHONE:206-225-2282 <br />CONTACT EMAIL: bcrawford@getchampion.com <br />BUILDING INFORMATION <br />Existing Use of Building:SFR <br />Contract Price of Work: $47592.90 <br />Proposed Use of Building:SFR <br />Heat Source: ❑Gas ❑Electric ❑Other <br />BUILDING USE: OSFR []Townhouse ❑Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑✓ Addition ❑Remodel [-]Repair ❑T.L ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />Construct unheated porch enclosure on back of existing SFR. <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />COUAI <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C — Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />Shower, Tub, or FNIb. <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pum &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 />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type 11) <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 />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/Insert/Log <br />I <br />Roof Drains <br />Water Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />I <br />INo. of Heads <br />Chemical Suppression System <br />I <br />INo. of Heads <br />ACKNOWLEDGEMENT. l 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 eny circumstance. I am the owner, or l 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 Lavl'l8.27 RCW and 296.200A WAC. <br />re <br />City of Everett Official Use Only <br />-76 PE `O <br />(Revised 1011012018) <br />