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To: E Page 2 of 3 2017-05-18 14:58:48 (GMT) 18884000383 From: Northwest Permit Inc. <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: 1317 MCDOUGALL AVE PROPERr,rTAX#00595200002602 P 0LJ0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER DARDNELL FALE Phone/E-mail 4253434715 <br /> Address 1317 MCDOUGALL AVE City/state/zip Everett WA 98201 <br /> APPLICANT: _Owner Owner's Agent __,Contractor ✓ Contractor's Agent Tenant(must provide a letter of consent from the ow•- ••. ork in the space) <br /> CONTRACTOR Sears Home Improvement Prod Inc State Lic. # SEARSHI011 LA City Bu ic.# R-24 <br /> Address 1024 Florida Central Pky Longwood FL 32750 Phone/Email 3609452787 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Jennifer Covello/Nor es ermit Inc. <br /> Phone/E-mail 360-945-2787' t er@a nwp rmit.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WO 9548.00 <br /> Existing Use of Building HEAT SO CE: <br /> Proposed Use of Building as tricT Other._. <br /> Building type: Single Family ,Dunie Townhouse Multi-Family _ Commercial <br /> Type of project: _New Addition ('Remodel Repair T.1. SignSprinkler Demolition__Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> RESIDENTIAL RE-ROOF: TEAR OFF EXSITING , INSTALL 30SQ OF ROOFING <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn Alteration Repair Type of Project: _New Addn Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory (wash basin) <br /> Water heater i Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> { Exhaust fan l Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> Unit heater <br /> Urinal <br /> Boiler I Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove i Grease trap <br /> Ducting ! Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> I Number of Heads <br /> 1 Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.At provisions of laws and ordinances governing this type of work will be comp! <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That lam authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18,27 RCW and 296.200A WAC. <br /> I <br /> Owner/Auth ' ed Agen gnature Date <br /> (Revised 9/2014) <br />