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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/ PLUMBING/SIGN /SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> •17., <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps©everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Iflk Only Please) , PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 3430 KROMER PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: DELLA VUE TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3430 KROMER <br /> cITY EVERETT STATE WA zip 98201 <br /> OWNER PHONE: 425.259.4286 OWNER EMAIL: <br /> CONTRACTOR NAME: EYLANDEER SALES & SERVICE <br /> CONTRACTOR ADDRESS: STREET 3601 EVERETT AVE <br /> CITY EVERETT STATE WA zip 98201 <br /> CONTRACTOR PHONE: 425.259.2161 CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): EYLANSSO42K2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):016363 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ctil OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:4255.231.2275 <br /> JOHN WITH TYPOS CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: C k( Contract Price of Work:$3000 <br /> Proposed Use of Quildin : F(�, Heat Source: ›'Gas ❑Electric ❑Other <br /> Building Type: FR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ONew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> REPLACE GAS FURNACE <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alteration Repair Type of Project: _New _Adds _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 /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> 1 Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> 1 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 /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I No.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 l am authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State ntractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> (1/5///,- PERMIT (gn g (O l <br /> Owner/A it •Ag t Signature te (Revised /23/20116) <br />