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PERMIT APPLICATION <br /> BUILDING MECHANICAL/ PLUMBING I SIGN / AINKLER/ 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) P...ROJECT SITE`INF.:ORMATION <br /> PROJECT SITE ADDRESS: 6028 Oakes Ave PROPERTY TAX#: 00495000101700 <br /> LEGAL for new construction: Short Plat/subdivisionLangs Ist Add to Evertt Blk 001 Lot No. 17-18(attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Teresa Gamiz TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 6028 Oakes Ave <br /> ciTv Everett STATE WA <br /> zip 98203 <br /> OWNER PHONE: 425-750-7247 OWNER EMAIL: <br /> CONTRACTOR NAME; Puget Sound Restoration <br /> CONTRACTOR ADDRESS: STREET 5802 Cemetery Rd#B <br /> ciTv Arlington STATE WA zip 98223 <br /> CONTRACTOR PHONE: 425-513-1378 CONTRACTOR EMAIL: kevinh@psrestorationinc.com <br /> CONTRACTOR LICENSE#(REQUIRED): PUGETSR893RF CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR M OTHER(Please Specify) Engineer <br /> CONTACT NAME: CONTACT PHONE: 253-833-5557 <br /> Jesse Binford CONTACT EMAIL: jbinford@bcie,net <br /> BUILDINGPERMIT APP...LICATION . <br /> Existing Use of Building: SFR Contract Price of Work:$ <br /> Proposed Use of Building: SFR Heat Source: ❑Gas PgElectric ❑Other <br /> Building Type: K)SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Famil -#of Units: ❑Commercial ❑Industrial <br /> Type of Project: EINew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sin []Sprinkler ❑Demolition ❑Chan a of Use <br /> DESCRIPTION OF WORK: <br /> Damage inspection of SFR hit by a tree <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> MECHANICAL PERMIT APPLICATION n/a :PLUMBING PERMIT APPLICATION 'n/a <br /> Type of Project: <br /> _Now _ Addn _Alteration _Repair Type of Project: New Addn _Alteration Repair <br /> #of List of Flxtures #of � #of <br /> Fixtures Fixtures List of Fixtures #of List of Fixtures List of Fixtures <br /> Fixtures Fixtures A/C—Air HandlingUnits 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 Wafer Heater <br /> Other: <br /> Exhaust Fan Sink (Service/Bar/Mop/etc. Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> Chemical or Water I I No. of Heads <br /> ACKNOWLEDGEMENT.-/have reviewed this application and confirm the information contained herein is true and correct Work done pursuant to this permit must comply with <br /> ;urrent 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 /> 3uilding Official before being authorized under any circumstance./am the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Lavti,98.27 RCW end 295.200A WAC. <br /> City of Everett Official Use Only <br /> ;Jj t.' Cxj 'f �•,/ PERMIT# <br /> ')wnar1Allfhnr6at!An..f <br />