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PERMIT APPLICATION <br /> BUILDING I MECHANICAL t PLUMBING/SIGN/SPRINKLER 1 DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@ovorottwa.gov I www.evorottwa.govlpermits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 2517 grand Ave Everett,Wa 98206 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Green Built Northwest IIC TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: craeET 17720 15th Ave Ne <br /> crrY Shoreline STATE Wa ZIP 98155 <br /> OWNER PHONE: 'OWNER EMAIL: <br /> CONTRACTOR NAME: Bear Plumbing and Heating <br /> CONTRACTOR ADDRESS: STREET PO box 64816 <br /> Car University Place STATE Wa ZIP 98464 <br /> CONTRACTOR PHONE: 2067348444 'CONTRACTOR EMAIL: andre@alistpiumbing.cam <br /> CONTRACTOR LICENSE#(REQUIRED): bearph 1973f j law OF EVERETT BUSINESS LICENSE#REQUIRED):56087 <br /> PRIMARY CONTACT: 0 OWNER ,CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2534684048 <br /> Andre Martinez CONTACT EMAIL: andre@alistolurnbino.com <br /> BUILDING PERMIT APPLICATION dry "' <br /> Existing Use of Building: Contract Price of Work:.. ID VVV•r)/ <br /> Proposed Use of Building: 'Contract Price <br /> ❑Gas °Electric DOther <br /> OCommerdai Olr�.atriai <br /> Building Type: ❑SFR-Detached °SFR Attached °Duplex ❑Multi-Family-#of Units: <br /> Type of Project: ❑New °Addition ❑Remodel ❑Repair °T.!. °Sign ❑Sprinkler °Demolition °Change of Use <br /> DESCRIPT N OF WORK: / _f� ,rte`•� �� 1�l <br /> p itrdc.4 41/'444-c— YI mrd Cc.., ,c "" 'fir�JJ <br /> ASSOCIATED`BUILDING PERMIT#.(If applicable): G I , 02.--0.11 <br /> •,: PLUMBING PERMITAPPP,J TION >?. <br /> MECHANICAL PERMIT APPLICATION r• of Project: New "_,Addn ration _Repair <br /> Type of Project: New,_- Addn Alteration_Repair Type trot List_R°fFixpair <br /> #or #or List of Fixtures <br /> Fixtures List of Fixtures Fixtures List of F/xtures Fixtures Bat9dlow Preventer(Inside Bldg) <br /> NC—Air Handling Units. Heat Pump t Toilet <br /> GasordBathtub `Urinal <br /> Air Systems Unit Heater I Lavatory(Wash Basin) Drinking Fountain <br /> Piping Boiler ( Floor Drain <br /> Water Heater Refrigeration Shower Drain <br /> Gas Fireplace Wood Stove ( Kitchen Sink&Disposal GreaseRoof Drains <br /> Ducting 1 Dishwasher <br /> Gas stes - , Clothes Washer Medical Gas <br /> Clothes Dryer Hookups Other: <br /> Range Hood Water Heater Other:Other: <br /> Exhaust Fan Sink Service/Bar/M••etc. <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> ]Chemical or Water 1 'No,of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm Me Information contained herein Is true and correct.Walt dona Fumed <br /> the p <br /> Ott rod in etTnit sl ct*!from current federal,State,and kcal law.The granting of a permit only authorizes approved wrkandnodeviationstherefrom.Deviadons cut forerlchn app mors <br /> Building Official before being authorized under any cir tanslance.tam the owner,cream authorized by the owner of this moped)*moped)*to P�?n the <br /> and I comply with the State Contractors Law 18.27 RCW and 296.2004 WAC, t;tlydl:lerett Official the Orly/;� <br /> PERMIT a i t In . <br /> ,..1, <br /> �//� i/sr�tii, (Re Alt' e} <br /> .razed Agent Signature Date `, <br /> Scanned by CamScanner <br />