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9 PERMIT APPLICATION 9 <br /> BUILDING / MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 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 INFLATION <br /> PROJECT SITE ADDRESS: 10205 7th Ave SE Everett WA PROPERTY TAX#: 004822000001 01 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Maksim Serglyenko TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET same <br /> CITY STATE ZIP <br /> OWNER PHONE: 206-902-8236 OWNER EMAIL: <br /> CONTRACTOR NAME: Dennis Killian Enterprises <br /> CONTRACTOR ADDRESS: STREET 935 13th St. SE <br /> CITY Puyallup STATE WA ZIP 98372 <br /> CONTRACTOR PHONE: 253-948-7812 1CONTRACTOR EMAIL: dk ualit windows mail.com <br /> CONTRACTOR LICENSE#(REQUIRED): DEN N I KE016KE ICITY OF EVERETT BUSINESS LICENSE#(REQUIRE[ <br /> PRIMARY CONTACT: ❑ OWNER ® CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-948-7812 <br /> DENNIS KILLIAN CONTACT EMAIL: dkqualitywindows@gmail.com <br /> BUILDING PERMIT APPLICATIO <br /> Existing Use of Building: single family dwelling Contract Price of ork:$ <br /> Proposed Use of Building: single family dwelling Heat Source: ❑G Electric ❑Other <br /> Building Type: ®SFR-Detached ❑SFR-Attached []Duplex []Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Pro ect: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sin ❑Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> Install 2 ductless heat pumps <br /> ASSOCIATED BUILDING PERMIT# if a licable <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 /> Ran e Hood Water Heater Other: <br /> Exhaust Fan Sink (Service/Bar/Mop/etc. Other. <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Chemical or Water I INo. 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 1 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 /> PERNi <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />