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PERMIT APPLICATION <br /> BUILDING_ CHANICAL/ PLUMBING /SIGN /= INKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> o 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE ADDRESS: 5-cc I J Rice PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> .,,> ate...>,,,,., .._.. .�� .���,., �....... ... ....a , ..t.;�,� t,�..-.,_ Why �. _f•_ .E, ,„ ., a,�.�, ..Z lig <br /> OWNER NAME: oyilt c_ Ark- U_C TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 777 c,by 40-e__ S(.4 l I-c ti eco <br /> CITY E wir 1 STATE Wll ZIP 9 V a <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@wolfepi.com 1 <br /> CONTRACTOR LICENSE#(REQUIRED): WOLFEPIO33CJ CITY OF EVERETT BUSINESS LICENSE#(REQUI D): 0326 <br /> - <br /> .. <br /> PRIMARY CONTACT: 0 OWNER IA CONTRACTOR 0 OTHER(Please Specify) , <br /> CONTACT NAME: Jake Adams CONTACT PHONE: 360-794-8621 <br /> CONTACT EMAIL: jakea@wolfepi.com <br /> Existing Use of Building: Contract Price of Work:$ q///000 <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric <br /> Building Type: DSFR-Detached ❑SFR-Attached ['Duplex ❑Multi-Family-#of Units: ['Commercial ['Industrial <br /> Type of Project: !3New DAddition ❑Remodel El Repair ❑T.I. ❑Sign ❑Sprinkler CI Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: i VC,/ <br /> ` p / <br /> C" '7 11 I'u(,l,/ ritty� ter. VstS1 tr `'t''�/ a br'eck rt`c,w.S q r\C�( d' kb-1 i fcc-5 r 0 NN <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <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 /> NC—Air Handling Units —Heat Pump j Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler I 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 I Water Heater Other: <br /> Exhaust Fan I Sink(Service/Bar/Mop/etc.) Other: <br /> t, :;;Z:,Ar,:',Itf94MOR.SCSI"CiStkagfi <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.lam the owner,or lam 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 /> -*--r----i - <br /> ! r �at��l/� <br /> t P T UOc: <br /> — O (1). <br /> Owner/Aut < ize Agent SI�na e (Revis d 5/20/2016) <br />