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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: 11030 EVERGREEN WAY, EVERETT WA 98204 PROPERTY TAX # P MIT #, <br />28042300400800 � ` � f �_ __ � � <br />for new construction: Short PlaUsubd <br />R PAULSTEPHANUS <br />1140 PARKSIDE DR. E. <br />No. (attach copy of long legal description) <br />Pho ne�E-ma il 206.329.9030 <br />City/State/Zip SEATTLE, WA 98112 <br />'LICANT: Owner X Owner's Agent _ Contractor _ Contractor�S Ag2flf _ T2f12f1t (must provide a letter of consent from the owner to do work in the space) <br />NTRACTOR L& I Lic. # COE Bus. Lic. # <br />ress Phone/Email <br />VANT BUSINESS NAME CONTACT FOR PERMIT <br />CAMELOT APARTMENTS - BUILDING'B' 206.763.8496-101 / MARK@MARKTRAVERSARCHITECT.COM <br />PhonelE-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT 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 />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />A/C — air handling units <br />� Forced air svstems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />on <br />SPRINKLER / SUPPRESSION SYSTE <br />i Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Bathtub <br />Shower <br />Kitchen sink & d <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelba <br />Backflow prever <br />Urinal <br />Drinking Founta <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify lhat I have r ad 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 here 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 />T t I am tho' b is property lo perform the work forwhich application is made and I comply with the Slale Contractors Law 18.27 RCW and 296.200A WAC. <br />� <br />,�,�3 �� <br />wner/Au orized Agent Signature Date (Revised 6/2012) <br />