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PERMIT APPLICATION <br /> I <br /> BUILDING I MECHANICAL/ PLUMBING I SIGN 1 SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(if Commercial): Ab So a <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTORNAME: Anderson Mech Ht &.C1&.C1q Inc <br /> I <br /> CONTRACTOR ADDRESS: STREET 8708 Arlington Heights Rd <br /> CITY Arlington STATE WA zip 98223 <br /> CONTRACTOR PHONE: 425-422-0160 1CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): ANDERMH837CP CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> ! <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) I <br /> CONTACT NAME: CONTACT PHONE: 4255-422-0160 i <br /> 1 <br /> Jesse Anderson CONTACT EMAIL <br /> = BUILDING PERMIT APPLICATION = — <br /> Existing Use of Building: Contract Price of Work:$ ^IU n✓ <br /> Proposed Use of Building: Heat Source: []Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex []Multi-Family-#of Units: ❑Commercial [Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sin ❑S rinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Ou&ess ,nL'eve (,Lr <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL_PERMIT:APPLICATION :PLUMBING PERMIT APPLICATLON <br /> Type of Project: _New_ Addn Alteration Repair Type of Project: New Addn Alteration Repair I <br /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of <br /> List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C-Air Handling Units I Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: U <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> a <br /> SPRINKLER7SUPPRESSIONSYSTEM,; . <br /> Number of Heads fF <br /> ACKNOWLEDGEMENT-l have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with l <br /> current federal,state,and local law.The granting 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> e <br /> hic" F <br /> c <br /> PERM <br /> ), i <br /> ;16r/Autho-ri-z-eTAgent'Signature Date (Revised 10/1212015) <br />