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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: 4812 Elm St, Everett Wa PROPERTY TAX#29043600401900 PERMIT# <br /> Of 11 b7-07-5 <br /> LEGAL for new construction: Short Plat/subdivision_ Lot No. (attach copy of long legal description) <br /> Rodden Blanche <br /> OWNER Phone/E-mail <br /> Address 4812 Elm St Everett, Wa 98203 City/state/zip <br /> APPLICANT:_Owner _Owner's Agent X Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> Statewide Restoration STATERI866KH <br /> CONTRACTOR State Lic.# City Bus.Lic.# 055;201-1 <br /> Address 13450 NE 177th PI Woodinville,Wa Phone/Email (425)829-4050 Vladb@domuscd.com <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Vlad Bondarenko <br /> (425)829-4050 Vladb@domuscd.com <br /> Phone/E-mail a n <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK UO( V UU <br /> Existing Use of Building Single Family Residence HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other_ <br /> Building type: X Single Family Duplex Townhouse Multi-Family Commercial <br /> Type of project: New Addition Remodel X Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): Fire Damage Repair, New Truss System To be installed <br /> In replacement of Existing Stick Frame Per Truss Manf. Layout. New Drywall, insulation,And windows as per Plans <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration X Repair Type of Project: _New_Addn _Alteration X Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units 1 Toilet <br /> 1 Forced air systems 1 Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace 1 Kitchen sink&disposal <br /> Gas range 1 Dishwasher <br /> I Clothes dryer 1 Clothes washer <br /> Range hood Water heater <br /> 2 Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All 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 I am 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 /> Vlad Bondarenko 7/14/17 <br /> Owner/Authorized Agent ignature Date (Revised 9/2014) <br />