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To: Permit Department Page 2 of 4 2017-12-30 03:48:51 (GMT) 18884000383 Frorn: Northwest Permit Inc. <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICALlPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereit, WA 9820'1 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SlTE ADDRESS:2�6 M�C�ISOfI St p�dPERTY TAX#003�ZOOOOOO�O9 R # 1 � ) I <br /> LEGAL for ne�v construction: Short Plat/subdivision _ Lot No.__ (attach copy of long legal description) <br /> o�NNEREIizabeth Calsyn Phone,��-mai�4253876065 <br /> Address216 Madison St c�cY;stace�z�pEverett WA 98203 <br /> Af'PLICANT: _Owner _Owner's Agent __Contractor � ontractor's Age�t _Tenant(must proviae a le,ter ur co:sent rron,me owner io ao wor;;n me spece� <br /> CONTRACTORSEARS HOME IMPROVEMNT PROD INC State Lic. # �EARSH101 1 LA City Bus Lic.# � � <br /> Address 1024 FLORIDA CENTRAL PKWY, LOngwood FL 32750 pt�one�Emai�36O-9452 <br /> TENANT BUSINESS NAME CONTACT FOR PER(UIIT <br /> Naida Khan/Northwest Permit Inc. <br /> Phone/E-mail 360-945-2787 n�ida@nwpermit.com <br /> BUILDING PERMtT APPLICATION CONTRACT PRICE OF WORK $�464•8Q <br /> Existing Use of 8uilding HEAT SOURCE- <br /> Proposed Use of Building Gas Electric Other <br /> Building type: X Singfe Family _ Duplex_Townhouse ❑Multi-Family _ Commercia3 <br /> T pe of project: New _Addition _Remodei � Re air T.L Si n S rinkler Demolition Cha� a of Use <br /> DE'_SCRIPTION OF WC1RK(additionaispace provided on the back): <br /> Re-roof. Replace 1500 sq ft roofing. No plywood replacement. <br /> MECHAN[CAL PERMIT APPLICATION PLUMBiNG PERMIT QPPLICATION <br /> Type of Project: _New_Addn _Alteration�Repair Type of Project: _New_Addn +Alteration,_Repair <br /> Show Number # of fixiures Show Number # of fixtures <br /> � A!C—air handlin units Toilet <br /> Forced air s stems j 8athtub <br /> Gas i in Lavato wash basin <br /> Water heater ; Shower <br /> Gas fire lace ; Kitchen sink 8�dis osai <br /> � Gas range ; Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> i Exhaus#fan i Sink service/barlmo /etc. <br /> i Heat um � Backflow reventer <br /> � Unit hsater Urinal <br /> Boiler Drinkin Fountain <br /> Refri erafion ! Floor drain <br /> Woodstove Grease trap <br /> � Ducting i Roof drains <br /> i Other i Medical Gas <br /> SPRINKLER / SUPPRESStON SYSTEM ' Other: <br /> Numberof Heads s Other: <br /> I hereby certify that I hav2 read and examined this applicatfon and know ihe same to be true and correct.All provisions of laws and ordinances governing this type of work will be compl <br /> with�vhether specified herein or not.The granting of a permit does not presume tu gNe authoriry to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authunzed by the owner of this property to pertorm the work for whidi applicaiion is made antl f comply wrth the State Conlractors Lativ 18.27 RCW and 2�i1i,200A WAC <br /> ' Digitally signed by Naida Khan <br /> �'�� ���� Date:2017.1229 19 48:01-08'00' <br /> Owner/Authonzed Agent Signature Date (Revised 9/2014) <br />