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lue or 61ack Ink <br />� PERMIT APPLICATION� <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 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />'leasel PROJECT $[T� [NFORMATION ' <br />SITE ADDRESS: 1824 Colbv Ave Everett WA 98201 <br />PROPERTY TAX #: 0043703690200 <br />for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />pWNER NAME: Sheldon and Stephanie Anderson TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: sTReeT 1602 Colby Ave <br />cirr Everett sTnre WA ziP 98201 <br />OWNER PHONE: 206 658-5922 OWNER EMAIL: Sheldon@marketstreetdev.com <br />CONTRACTOR NAME: Axiom HVAC Inc. <br />CONTRACTOR ADDRESS: 2232�adwa Ave. Suite 101 <br />ciTv Everett srAre WA zia 98201 <br />CONTRACTOR PHONE: CONTRACTOR EMAIL: James@axiomnw.com <br />CONTRACTOR LICENSE #(REQuiRE�): AXIOMH1892RM CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): D �� <br />PRIMARY CONTACT: C�OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: 206 658-5922 <br />Sheldon Anderson CONTACT EMAIL: Sheldon marketstreetdev.com <br />BUILDING RERMIT APPLICATION <br />Existin Use of Buildin : Contract Price of Work: $1500 00 <br />Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br />Buildin T pe: OSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Famil -# of Units: ❑Commercial ❑Industrial <br />T pe of Pro'ect: ❑New ❑Addition ❑Remodel ❑Repair �T.I. ❑Si n ❑Sprinkler ❑Demolition ❑Chan e of Use <br />DESCRIPTION OF WORK: <br />IV�'C/V � I�v� �J }�'Vr'� <br />1 <br />ASSOCIATED BUILDING PERMIT # if a licable : <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br /># of List of Fixtures # of List of Fixtures <br />Fixtures Fixtures <br />Toilet Backflow Preventer (Inside Bld ) <br />Bathtub Urinal <br />Lavato (Wash Basin) Drinkin Fountain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher Roof Drains <br />Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/Bar/Mop/etc.) Other: <br />ACKNOWLEDGEMENT. 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br />cunent 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 Officia/ before being authorized under any circumstance. 1 am the owner, or I am authorized by the owner of this property to pertorm the work for which app/ication is made, <br />and I comp/y with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />��(-r6 <br />Agent Signature <br />City of Everett Official Use Only <br />PERMIT # ^ ,� r ( !., n J�� <br />V►'ll�%U�� <br />(Revised 5/20/2016) <br />, <br />