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® PERMIT APPLICATIO <br /> sil <br /> BUILDING4I1ECHANICAL / PLUMBING / SIGNr.RINKLER / 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: 5403 Colby, Everett WA 98201 PROPERTY TAX#: 00495800100602 <br /> LEGAL for new construction: Short Plat/subdivision see attached Lot No.7 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Accommodations Northwest TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET PO Box 595 <br /> CITY Edmonds STATE WA ZIP 98020 <br /> OWNER PHONE: 425-328-5158 OWNER EMAIL: burchcambers@yahoo.corr1 <br /> CONTRACTOR NAME: Sellentin True Design Build <br /> CONTRACTOR ADDRESS: STREET785 16th Place, Suite 101 <br /> Cm, Mukilteo STATE WA ZIP 98275 <br /> CONTRACTOR PHONE:206.715.2452 CONTRACTOR EMAIL: jeff@sellentininc.Corn <br /> CONTRACTOR LICENSE#(REQUIRED):SELLETD890O2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): ;)- - <br /> PRIMARY CONTACT: El OWNER El CONTRACTOR 0 OTHER(Please Specify) k(pD7 310 12--3 <br /> CONTACT NAME: ICONTACT PHONE:425-328-5158 <br /> Burch Cambers !CONTACT EMAIL: burchcambers@yahoo.com <br /> BUILDING INFORMATION <br /> Existing Use of Building: Duplex- Up Stairs and Down Contract Price of Work: $ 10,000 <br /> Proposed Use of Building:SitrdE Si—. Heat Source: ❑Gas ❑Electric ❑Other <br /> BUILDING USE: ❑SFR ❑Townhouse LJDuplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑Addition ❑Remodel Li Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition EChange of Use <br /> DESCRIPTION OF WORK: Conduct Select Demo in Existing Lower Unit of Duplex. Remove Non- <br /> Bearing walls and finishes. Properly insulate existing space with <br /> furring a d batt insulation. Maintain existing electric wall heat. <br /> CtwpO27li✓4 - v.✓fi v/s//Ev s p cE <br /> ASSOCIATED BUILDING PERMIT#(if pplicable): <br /> MECHANICAL PERMIT APPLICATION c PLUMBING PERMIT APPLICATION, <br /> Fixture Fixture Fixture Fixture <br /> List of Fixtures Count List of Fixtures List of Fixtures %'List of Fixtures <br /> Count <br /> Count*' Count <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) I Sh er,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Ink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher ,,,. Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain I 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 /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas I Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drain. Water Heater — _` <br /> SPRINKLER/ SUPPRESSION SYSTEM 5c4age Ejector or Sump Pump X Other: REMOVE/CAP EXISTING FIXTURES <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System ` 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 /> -• City of Everett Official Use Only <br /> • PEW/iJv��O4 <br /> 02/1112020 <br /> Owner/Au oriz d ge Signatul Jeff r C.S entin,Owner Agent Date (Revised 10/10/2018) 72_ <br />