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PERMIT APPLICATIO <br />BUILDIN�ECHANICAL / PLUMBING / SIGN RINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 34,1 O Oak�S AVe PROPERTY TAX #: <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />J.A. Homes. LLC-Josh, Alison Jessup <br />OWNER NAME: on b�na�f ot owner �see attacned) TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: sTREer 909 Harvest Rd <br />�,n Bothell STATE WA Z,P 98012 <br />OWNER PHONE: 425-77O-�J626 OWNER EMAIL: losh.jessup@hotmail.com, <br />alisonm essu @ mail.com <br />CONTRACTOR NAME; Owner Builder (.losh Jessup <br />CONTRACTOR ADDRESS: sTREET <br />CITY STATE ZIP <br />CONTRACTOR PHONE: CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR 0 OTHER (Please Specify) �OSII .�@SSUp <br />CONTACT NAME: ,JOSiI .J2SSUp CONTACT PHONE: 425-770-5626 <br />CONTACT EMAIL: ��S�1.f �JiUfJ�PiO$Ill�II.C�ii1 <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: ��R <br />Proposed Use of Building: SFi� <br />Building Type: �SFR-Detached ❑SFR-Attached ❑Dupl <br />Type of Project: ❑New ❑Addition mRemodel ❑Repair <br />DESCRIPTION OF WORK: <br />See attached for scope of work. <br />SOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _ Addn i Alteration _Repair <br />Fi tures List of Fixtures Fixtu es List of Fixtures <br />A/C — Air Handling Units Heat Pump <br />Forced Air Systems Unit Heater <br />Gas Piping Boiler <br />Water Heater Refrigeration <br />Gas Fireplace Wood Stove <br />Gas Range Ducting <br />1 Clothes Dryer Hookups Other: <br />1 Range Hood <br />� Exhaust Fan <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Contract Price of Work: $ �'rJQ,��Q <br />Heat Source: �Gas ❑Electric ❑Other <br />❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />❑T.I. ❑Sian ❑Sprinkler ❑Demolition ❑Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn ! Alteration _Repair <br /># of List of Fixtures # of List of Fixtures <br />Fixtures Fixtures <br />Toilet Backflow Preventer (Inside Bldg) <br />1 Bathtub Urinal <br />2 Lavatory (Wash Basin) Drinking Fountain <br />� Shower Floor Drain <br />1 Kitchen Sink & Disposal Grease Trap <br />Dishwasher Roof Drains <br />1 Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/Bar/Mop/etc.) Other: <br />ACKNOWLEDGEMENT: 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must compty with <br />current federal, state, and local law. The g�anting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under any circumstance. I am the owner, or I am authorized by the owner of this property to perform the work for which application is made, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Signature <br />-- J � „ <br />Date <br />City of Everett Official Use Only <br />PERMIT # <br />�.lCV � � �� � <br />(Revised 10/12/2015) � <br />