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• • <br /> PERMIT APPLICATION <br /> BUILDING I 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 l www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3525 Lomabard Ave PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Leah Alejandro TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3525 Lombard Ave <br /> cnv Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425-953-0682 OWNER EMAIL bowers.Iea©cmall.Com <br /> CONTRACTOR NAME: SeaTown Electric Corp. <br /> CONTRACTOR ADDRESS: STREET 3431 Broadway <br /> cry Everett STATE WA zr 98202 - <br /> CONTRACTOR PHONE: 206-905-3690 CONTRACTOR EMAIL: makayla@seatownelectric.com <br /> CONTRACTOR LICENSE#(REQUIRED): SEATOEH821 DG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 53916 <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) i <br /> CONTACT NAME: CONTACT PHONE: 206-905-3690 `, - <br /> Makayla Roe CONTACT EMAIL: makaylaeatownelectric.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:Restindentai Contract Price of Work:$20,000AO' <br /> Building Type: OSFR-Detached ❑SFR-Attached ['Duplex ❑Multi-Family-#of UnGas ❑Electric ['Other <br /> Proposed Use of Building: Heat Source: el <br /> y its ^�['Commercial ❑Industrial <br /> Type of Project: New ❑Addition ['Remodel ❑Repair ❑T.I. ❑Sign ['Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> 2 New gaslines from 2 new meters.Downstairs:tankless dryer and range.Upstairs:water heater range and dryerNew 18k ducted duckling In attic.New 12k ductless in basement <br /> ASSOCIATED BUILDING PERMIT#(if applicable): E1805-124 ,rj L'\ACvi ii'6,,, 4r 1. r--i'.-i,iLzI( 71X <br /> MECHANICAL PERMIT APPLICATION ' PLUMBING PERMIT APPLICATION <br /> Type of Project: , /New _ Addn Alteration _Repair Type of Project: _New _Addn Alteration _Repair <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units 1 Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Healer Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin'} Drinking Fountain <br /> Water Heater ..., Refrigeration Shower Floor Drain <br /> Gas Fireplace W and Stove ' Kitchen Sink&Disposal ,Grease Trap <br /> 2 Gas Range Ducting Dishwasher Roof Drains <br /> 1 Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc. Other: <br /> . <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Chemical or Water I No.of Heads <br /> a <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!am authorized by the owner of this property to perform the work for which application is made, <br /> and I a y Contractors Law 18.27 RCW and 296.200A WAC. <br /> - f City of Everett Official Use Only <br /> I <br /> P-A9-) <br /> PERMI— <br /> 21 <br /> a ., 11,4. j <br /> O ner uthoriz ge Signature Date 1 (Revised 9/23/2016) <br />