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PERMIT APPLICATIO <br /> BUILDIN*ECHANICAL / PLUMBING / SIGN RINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 447T 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 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: l` �7 C_ PROPERTY TAX#: OoL439 /625-00I <br /> LEGAL for new construction: Short Plat/subdivision 1 Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: �}(�G� �v(G4f t t6t LLL TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 7 7 <br /> CITY --v,(' STATE L/ ZIP b <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Wolfe Plumbing <br /> CONTRACTOR ADDRESS: STREET 17321 Tye St SE #B <br /> CITY Monroe STATE WA zip 98272 <br /> CONTRACTOR PHONE: 360-794-8621 CONTRACTOR EMAIL: jakea@Wolfepl.Com <br /> CONTRACTOR LICENSE#(REQUIRED): WOLFEPI033CJ ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 032640 <br /> PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: Jake Adams CONTACT PHONE: 360-794-8621 <br /> CONTACT EMAIL: jakea@Wolfepl.Com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work: $ <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. ❑Sign ❑Sprinkler ❑Demolition El Change of Use <br /> DESCRIPTION OF WORK: ! i�tSG�IIL'J'7'JC1�5 v'Alei <br /> Eicf� ' t`P-ry" <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 3 Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting :i Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood 2 Water Heater Other: j- {y;,; y, <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Z Other: C44l <br /> lac, �^ ��r �, •,I. <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT:1 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 /> "X/ - - <br /> Owner/Authori ' , gent Signature ��� Date (Revised 5/20/2016) <br />