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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERitkMOLITIO <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: 7PROPERTY TAX# P IT# <br /> 2008 23rd St Everett WA 98201 L /I )() <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Eastham James/ Bell Ashley Phone/E-mail <br /> Address 2008 23rd St City/State/Zip Everett WA 98201 <br /> APPLICANT:_Owner _Owner's Agent Contractor _Contractor s Agent _Tenant(must provide a letter of consent from the owner io do work in the space) <br /> CONTRACTOR Walker specialty Constr ction In, L&I Lic.# COE Bus.Lic.# (yll 666 <br /> Address 22221 We A qRQ72 Phone/Email 206-361-8913 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Walker Specialty Construction Inc. Larry Stumpf 206-718-5677 larrrys@wsconline.net <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building Burned out Residence HEAT SOURCE: <br /> Proposed Use of Building Re-build of Residence Gas Electricv Other <br /> Building type: VSingle Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair T.I. Sin_Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> f11v/.5/4 ,sxs1s14i.�ySflzvcfl•ee? /� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas ran a Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of this roperty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> � rJ <br /> Z;ner/Autho' ed Agent Signature �- Date (Revised 6/2012) <br />