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4PERMIT APPLICATIOP <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 /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> 5611 COLBY AVE. EVERETT, WA 98203 00495800200600 1 C I r ! — CC <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER ADAN BALANGUE Phone/E-rnail 425-344-9844 <br /> Address 6802 CADY ROAD City/State/Zip EVERETT WA 98203 <br /> APPLICANT:—owner X Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR OWNER State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> N/A RON MACTAL <br /> Phone/E-mail 425-786-3247 RONMACTAL@YAHOO.COM <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK -7f 0 ' <br /> E% <br /> Existing Use of Building RESIDENTIAL, SINGLE FAMILY HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: X Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition X Remodel Re air T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> CONVERT WALK-IN CLOSET AS A NEW BATHROOM, RENOVATE MAIN BATH, AND CONVERT <br /> MASTER BATH INTO A BEDROOM. THIS RENOVATION IS FOR AN ADULT FAMILY HOME CONVERSION. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units 2 Toilet <br /> Forced airs stems Bathtub <br /> Gas piping 2 Lavatory wash basin <br /> Water heater 2 Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify 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 type of work will be comp <br /> with whether specified herein 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 /> That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Agent Signatu.0 / e (Revised 4/2015) <br /> t / <br />