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� s <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: PROPERTY TAX # PERMIT #; , <br />11030 EVERGREEN WAY, EVERETT WA 98204 00442900300405 � h�, ��-- � <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER PAUL STEPHANUS PhonelE-mail 206.329.9030 <br />Address 1140 PARKSIDE DR. E. City/StatelZip SEATTLE, WA 98112 <br />APPLICANT: _ Owner X Owner�S Ag@flt _ COf1tf8CtOf _ COf1tf8CtOf S Ag2flt _ T21l8f1t (must provide a letter of consent From the owner to do work in the space) <br />CONTRACTOR L& I Lic. # COE Bus. Lic. # <br />Address PhonelEmail <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />CAMELOTAPARTMENTS - BUILDING'D' 206.763.8496-101 / MARK@MARKTRAVERSARCHITECT.COM <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $250,000 <br />Existing Use of Building APARTMENTS <br />Proposed Use of Building APARTMENTS Gas_ <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 (additiona/ 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 (#) of fiutures <br />A/C — air handling units <br />Forced air s stems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Exhaustfan <br />Heat pump <br />Unit heater <br />� Ducting <br />Other <br />SPRINKLER / SUPPRESSION <br />': Number of Heads <br />TEM <br />HEAT SOURCE: <br />X Electric Other <br />of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Bathtub <br />basi <br />Shower <br />Kitchen sink & disp� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have rea and examined this application and know the same to be lrue and correct. All provisions of laws and ordinances goveming this rype of work will be complied <br />with whether specified herein not. The ranting of a permil does not presume to give authority to violate or cancel the provision of any other stale or local law regulating construction <br />Tbat I am ayWorized b w er of this property fo perform lhe work for which application is made and I comply with the State Conlractors Law 18.27 RCW and 296.200A WAC. <br />Agent Signature <br />, Z� • 3� <br />Date <br />(Revised 6/2012) <br />y <br />