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417-7. PERMIT APPLICATION <br /> BUILDING . .MECHANICAL/ PLUMBING / SIGN /aPRINKLER/ 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:4600 Baker Drive PROPERTY TAX#:00417400001400 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Tom Jones TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET4600 Baker Drive <br /> ciTY Everett STATE WA ZIP 98203 <br /> OWNER PHONE: OWNER EMAIL:twjones3@gmail.com <br /> CONTRACTOR NAME:TBD b t o-k-- 10.014,.ll.k a-IV\ 1A,)ppc£t.004-l'S L Lc- <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: {� i `n CONTRACTOR EMAIL: , <br /> ,CONTRACTOR LICENSE#(REQUIRED): 1 J 1,- V�G r M /v .. RIDJkil A CITY OF EVERETT BUSINESS LICENSE#(RE IRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR O OTHER(Please Specify) Architect <br /> CONTACT NAME: CONTACT PHONE:425-242-0369 <br /> J3 Architects- Neil Jorgensen CONTACT EMAIL:neil@j3-Ilc.com <br /> BUILDING INFORMATION p� <br /> Existing Use of Building:Residential Contract Price of Work:$ C O. <br /> Proposed Use of Building:Residential Heat Source: OGas DElectric ❑Other <br /> BUILDING USE: OSFR ❑Townhouse LiDuplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑✓Addition ❑✓Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: ADDITION: 214 SF ADDITION TO EXIST. SINGLE FAMILY RESIDENCE, 290 SF COVERED DECK <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> List of Fixtures List of Fixtures List of Fixtures List of fures <br /> Count Count <br /> Count Count <br /> A/C—Air Handling Units Gas Piping Backflow Preve (Inside Bldg) 1 Shower,T rCombo <br /> Boiler 1 Gas Range 1 Clothes Washer Sink- mercial(3-comp,prep,floor) <br /> 1 Clothes Dryer Heat Pump&Ductless 1 Dishwasher 2 ysirfk-/Residential(kitchen,bath,bar) <br /> Duct System(Remodel) .----1----R6-i>robrn. Drinking Fountain 1 Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb `'' Urinal <br /> Exhaust Hood(Type II) 1 Water Heater Interceptor-Grease te/Water Piping Repair <br /> 1 Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water •ce(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves ure <br /> Gas Fireplace/InserULog Roof Drains 1 Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewag-,`jector or Sump Pump Other: <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 con ained 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 /> 01.26.21. P 2lo -OOP <br /> Owner Authorized Agent ignature Date (Revised 10/10/2018) <br />