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PERMIT APPLICATION <br /> BUI LDI NG/M EC HAN ICAL/PLU M B1 NG/S IG N/S PRI N KLERftffMOLITIO <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: PROPERTY TAX# PERMIT# <br /> 2010 23rd St Everett WA 98201 I �LICi <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Chachulski Paul Phone/E-mail <br /> Address 2010 23rd St City/State/Zip Everett WA 98201 <br /> APPLICANT:—Owner _Owner's Agent Vcontractor —Contractors Agent _Tenant(must Provide a letter of oonsem from the owner to do work in the space) <br /> CONTRACTOR Walker Specialty Construction Inc. L&1 Lic.# COE Bus.Lic.# <br /> Address 20221 West Bostman Rd WoodinvwLLCMA 99072 Phone/Email206-361-R91 3 <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 V Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back) <br /> %/�1rfS{ ��if+�e�ifiov/ SfaQ��� Iby ol�er F1' <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'Di in Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas ran ga 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 cerfify 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 /> Tha4thi <br /> the owner of property 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 /> I Z <br /> �' L <br /> wgent Signatu ate (Revised 6/2012) <br />