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�� <br /> PERMIT APPLICATION �r�` � <br /> BUILDING / MECHANICAL/ PLUMBING / SIGN /SPRINKLER / D U� <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 /> PRo�eeTs�TEA��Ress: �1031 PAINE FIELD WAY PROPERTYTAX#: <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: ROY MCDONALD TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sraeer 11031 PAINE FIELD WAY <br /> c�rv EVERETT STATE WA ziP 98204 <br /> OWNER PHONE: 425-876-5786 OWNER EMAIL: <br /> CONTRACTOR NAME: BLUE FLAME HEATING AND AIR CONDITIONING <br /> CONTRACTOR ADDRESS: sTaeer 7116 220TH ST SW,#1 <br /> c�rv MOUNTLAKE TERRACE STATE WA z�P 98043 <br /> CONTRACTOR PHONE: 425-771-7139 CONTRACTOR EMAIL: INFO@BLUEFLAMECOMFORT.COM <br /> CONTRACTOR LICENSE#(REQUIRED): BLUEFFH865JB CITY OF EVERETT BUSINESS LICENSE#(RE�UIRED): 052790 <br /> PRIMARY CONTACT: C�OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-771-7139 <br /> NAQUIN GRAY CONTACT EMAI�: INFO@BLUEFLAMECOMFORT.COM <br /> BUILDING PERMIT APPLICATION <br /> Existin Use of Buildin � <br /> 9 g: C��- � Contract Price of Work:$ 3�'"� <br /> � <br /> Proposed Use of Building: � t9..�Y\�-L� Heat Source: as ❑Electric ❑Other <br /> Building Type: FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Pro'ect: ❑New ❑Addition ❑Remodel epair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> ��. �c�v�� t-u--�✓tu.�� C �na--vtaxC.- Oti� <br /> !��� U <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration �Repair Type of Project: New Addn _Alteration Repair <br /> Fixtures List of Fixtures Fi�ctures List of Fixtures Fixtures List of Fixtures Fixtures List of Fi�ciures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> 1 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: <br /> Exhaust Fan Sink (Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations iheiefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.I am the owner,or 1 am authorized by the owner of this property to perfo�m the work for which application is made, <br /> and I compl with the State Contract s Law 18.27 RCW and 296200A WAC. <br /> Ciry of Everett Official Use Only <br /> (,l,Lw 4/5/17 P�tn�Tr C--� ' <br /> UV� \ <br /> Ow er/Aut r ed Agent Si a re Date (Revised 10/12/2015) <br />