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EOM <br /> PERMIT APPLICATIO• <br /> BUILDINOMECHANICAL/ PLUMBING /SIGN /SPRINKLER / DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I wwv.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 10632 Rosewood Ave, Everett, WA 98204 <br /> PROPERTY TAX#:00552300500101 <br /> LEGAL for new construction: Short Plat/subdivision <br /> Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Rodney&Victory Lucas <br /> TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 26828 Maple Valley Hwy#308 <br /> CITY Maple Valley STATE WA <br /> OWNER PHONE: 206-501-6379 ZIP 98038 <br /> !OWNER EMAIL:indigoenterprises@gmail.com <br /> CONTRACTOR NAME:Peter Krenzke/indigo Enterprises, LLC <br /> CONTRACTOR ADDRESS: STREET 26828 Maple Valley Hwy#308 <br /> GTY Maple Valley STATE WA <br /> CONTRACTOR PHONE:206-501-6379 zIR 98038 <br /> !CONTRACTOR EMAIL:indigoenterprises@gmail.com <br /> CONTRACTOR LICENSE#(REQUIRED):INDIGEL975LW <br /> !CITY OF EVERETT BUSINESS LICENSE#(REQUIRED); NAICS 23611562116 <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-501-6379 <br /> Peter Krenzke CONTACT EMAIL:indigoenterprises@gmail.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:dwelling <br /> !Contract Price of Work:$ 4. ' "e(✓.C.'L'' <br /> Proposed Use of Building: <br /> Heat Source: ❑Gas ❑Electric OOther, <br /> BUILDING USE: ❑SFR ❑ pTownhouse ❑Du lex []qpU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New 0/Addition ❑Remodel ❑Repair DTI. ❑Sign ❑Sprinkler +✓Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Demo old mobile home . <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> Fixture List of Fixtures Fixture Fixture PLUMBING PERMIT APPLICATION <br /> Count List of Fixtures Fixture <br /> Count List of Fixtures List of Fixtures <br /> NC—Air Handling Units Gas Piping Count <br /> Boiler Backflow Preventer(Inside Bldg) Shower, Tub, or Combo <br /> Gas Range Clothes Washer <br /> Clothes Dryer Heat Pump&Ductless Sink-Commercial(3-comp,prep,floor) <br /> Duct System(Remodel Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Refrigeration Drinking Fountain <br /> Exhaust Fans(Residential) Commercial Ventilatio Sink-Utility, laundry, mop <br /> Exhaust Hood(Type I) Floor Drain Toilet <br /> (Not Heat/AC system) Hose Bibb <br /> Exhaust Hood(Type II) Water Heater Urinal <br /> Exhaust Hood Teidential Interceptor-Grease Waste/Water Piping Repair <br /> ( ) Wood Stove Interceptor-Sand/Oil Forced Air Systems Other: Water Service(behind meter) <br /> Gas Fireplace/Insert/Log Medical Gas Water Valves or Fixtures <br /> SPRINKLER/SUPPRESSION SYSTEM Roof Drains Water Heater <br /> Water Suppression System Sewage Ejector or Sump Pump Other <br /> Chemical Suppression System I INo.of Heads <br /> No.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 /> 9 City of Everett Official Use Only <br /> . / 1?^ ti �;I 1 6 r ,3��"� / / PE MIT. <br /> . �, ,` 1 I -- 0�2 <br /> utllorized Agent Signature bate <br /> a ` ( evlsed Oh <br />