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PERMIT APPLICATION <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3701 Rockefeller AVE! Everett, WA 98201 PROPERTY TAX#: <br /> LEGAL for new construction' Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Jason Bontrager TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 4230 Ridgemont Drive <br /> CITY Everett STATE WA Z,P 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Forecast Roofing LLC; <br /> CONTRACTOR ADDRESS: STREET 4463 Russell Rd Suite 105 <br /> c,T, Mukilteo STATE WA ZIP 98275 <br /> CONTRACTOR PHONE: 425-487-6000 CONTRACTOR EMAIL: info@forecastsolar.com <br /> CONTRACTOR LICENSE#(REQUIRED): FORECRL955MK CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 044167 <br /> PRIMARY CONTACT: ❑ OWNER CYCONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-487-6000 <br /> Greg Nash CONTACT EMAIL: info@forecastsolar.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Residential I Contract Price of Work:$ 12,500 <br /> Proposed Use of Building: Residential Heat Source: ❑Gas ❑Electric ❑Other <br /> Buildinq Tye: SFR-Detached ❑SFR-Attached ❑Du lex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition Remodel []Repair El T,1. ❑Sin ❑Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> Complete tear off existing roof. <br /> Replace decking and install 301b underlayment & <br /> composition shingles <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 /> #of List of Fixtures #of List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units 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: <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 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 /> City of Everett Official Use Only <br /> PERMIT <br /> 7/20/2016 v <br /> Owner/Authorized Agent Signature Date (Revise 5/20/2 1 <br />