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II'''' II '' PERMIT APPLICATIO <br /> BUILDINl +MECHANICAL/PLUMBING/SIGN! PRINKLER I DEMOLITION <br /> '1111.10116‘,/-----4CITY OF EVERETT PERMIT SERVICES <br /> ' y 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 /> I1 e o Btacit nk Only Please) ,.. _= E ` `sj*Eitis `'It . <br /> PROJECT SITE ADDRESS: 2302 Baker Ave PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> `A :INF`OR1►1f1A'TION <br /> OWNER NAME: Mabel Andersen (estate of) TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> cm STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Integrity Roofing N.W., Inc. <br /> CONTRACTOR ADDRESS: smEET 7510 Braemar Dr <br /> cm Edmonds STATE WA zip 98026 <br /> CONTRACTOR PHONE: 425-743-1010 CONTRACTOR EMAIL: integritynw@comcast.net <br /> CONTRACTOR LICENSE#(REQUIRED): INTEGRN023.JG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): l`,"x' <br /> . . _. <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR P OTHER(Please Specify) Guardianship <br /> CONTACT NAME: CONTACT PHONE:206-898-6810 <br /> Jim Auld CONTACT EMAIL: <br /> .... ltRB**PEl >4T AP ` •'ION . 1 <br /> Existing Use of Building: Contract Price of Work:$ i iii J1 i <br /> � v n V <br /> Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: OCommercial ❑Industrial <br /> Type of Project: (New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition OChange of Use <br /> DESCRIPTION OF WORK: <br /> fit-eeOP of Hov5, <br /> O p liilcr-STrAiG ieooF ati4f'five erioG c w.-TK Ai gw 200 ntiF <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT PUCATIOH L PL1 MBING fi IT APPLICATION <br /> Type of Project: New _ Addn Alteration Repair Type of Project: _New Addn _Alteration _Repair <br /> Fixtures List of Fixtures Fixtures List of Fixtures List of Fixtures Fixtures List of Fixtures <br /> FixturesA/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 /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> 8PR1N11R0IIPP101010N.SYE7` ill <br /> Chemical or Water I (No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confine 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 I 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 298.200A WAC. <br /> 7 City of Everett Official Use Only <br /> PERMIT <br /> CwnAt1Authorized Agent Signature Date (Revised 9/23/2016) <br />