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� • <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <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 />ITE ADDRESS: PROPERTY TAX # P RMIT # ` ` <br />11030 EVERGREEN WAY, EVEREl7 WA 98204 28042300400800 'k�. ` hi �') �C''/O�L <br />for new construction: Short PlaUsubdiv <br />R <br />ress <br />PAULSTEPHANUS <br />1140 PARKSIDE DR. E. <br />No. (attach copy of long legal description) <br />Phone/E-mail 206.329.9030 <br />City/State/Zip SEATTLE, WA 98112 <br />�LICANT: Owner X Owner's Agent _ Contractor _ Contractor�S AgEf1t _ TBf1811f (must provitle a letter of consent from the owner to do work in the space) <br />NTRACTOR L& I Lic. # COE Bus. Lic. # <br />ress PhonelEmail <br />VANT BUSINESS NAME CONTACT FOR PERMIT <br />CAMELOT APARTMENTS - BUILDING 'A' 206.763.8496-101 / MARK@MARKTRAVERSARCHITECT.COM <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />NTRACT PRICE OF WORK $250,000 <br />Existing Use of Building APARTMENTS HEAT SOURCE: <br />Proposed Use of Building APARTMENTS Gas X Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New _ Addition _ Remodel X Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />REMEDIATION OF EXTERIOR AND BELOW-GRADE OF EXISTING APARTMENT BUILDING. <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />! Ducting <br />Other <br />SPRINKLER / SUPPRESSION SY <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />5how Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatorv (wash basin) <br />Kitchen sink & <br />Dishwasher <br />Clothes washE <br />Water heater <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify lhat I have read and examined this application and know lhe same to be true and correct. All provisions of laws and ordinances goveming this type oiwork will be complied <br />with whether specifed he in or noL The granting of a permit does not presume to give authoriry to violate or cancel the provision of any other state or local law regulating construction <br />T al I am uth ' rty 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 />�z�• <br />Owner/A thorized Agent Signature Date (Revised 6/2012) <br />�"�v <br />