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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 />ADDRESS: 11030 EVERGREEN WAY, EVERETT WA 98204 PROPERTY TAX # P MIT #- <br />28042300400800 � � -�' � _ �� <br />for new construction: Short Platlsubd <br />ER <br />ress <br />PAULSTEPHANUS <br />1140 PARKSIDE DR. E. <br />e <br />LICANT: Owner %� Owner's Agent _ Contractor <br />CONTRACTOR <br />CAMELOT APARTMENTS - BUILDING 'C' <br />BUILDING PERMIT APPLICATION <br />Lot No. <br />PhonelE-mail <br />City/State/Zip <br />Contractor's Agent _ <br />L & I Lic. # <br />(attach copy of long legal description) <br />206.329.9030 <br />SEATTLE, WA 98112 <br />T81l8f1t (must provide a letter of consent from the owner to do work in the space) <br />Phone/Email <br />COE Bus. Lic. # <br />206.763.8496-101 / MARK@MARKTRAVERSARCHITECT.COM <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building APARTMENTS <br />Proposed Use of Building APARTMENTS Gas X <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New _ Addition _ Remodel X Repair _ T.I. _ Sign _Sprinkler _Dem <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 s stems <br />Gas piping <br />Water heater <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION <br />� Number of Heads <br />$250,000 <br />HEAT SOURCE: <br />Flectric Othe� <br />Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Shower <br />Kitchen sink & disposal <br />Clothes washer <br />Water heater <br />Sink (service/bar/i <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby cerlify 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 rype of work will be complied <br />with whelher specified her 'n or not. The granting of a permit does not presume lo give authority to violate or cancel the provision of any other slate or local law regulating conslruction <br />T t I am horize ow is-pcoperty to perform the work for which application is made and I comply with the Stale Contractors Law 18.27 RCW and 296200A WAC. <br />c <br />. 2� � t � �� <br />O ner/Authonzed Agent Signature Date (Revised 6/2012) <br />