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4.77 PERMIT APPLICATION <br /> BUILDING/ MECHANICAL/ PLUMBING l SIGN/SPRINKLER / 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@everettwa.gov I www,everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 5615 Sunset Lane, Everett, WA 98203 PROPERTY TAX#: 00471800001500 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Scott Pattison TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 5615 Sunset Lane <br /> circ Everett STATS WA op 98203 <br /> OWNER PHONE: 425-870-5606 OWNER EMAIL: <br /> CONTRACTOR NAME: D.K. Systems, INC. <br /> CONTRACTOR ADDRESS: STREET PO Box 886 <br /> cry Burlington STATE WA ZIP 98233 �.. <br /> CONTRACTOR PHONE:360-755-1555 CONTRACTOR EMAIL: tamit dksystemsinc.com <br /> CONTRACTOR LICENSE#(REQUIRED): DKSYSI*982L1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRE:@): 049744 <br /> PRIMARY CONTACT: 0 OWNER Igl CONTRACTOR D OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> Kevin Korthuis 360-770-7981 <br /> CONTACT EMAIL: kevin@dksystemsinc com <br /> — <br /> r N <br /> BUILDING PERMIT APPLICATiOP4. N <br /> Existin. Use of Buildin.: Residence Contract Price of Wor`:$1,500.00 <br /> Proposed Use of Building: Residence Heat Source: filGas ',DElectrif DOther <br /> Building Type: ®SFR-Detached DSFR-Attached DDupiex @Multi-Family-#of Units: ommercial ❑Industrial <br /> Type of Project: ®New DAddition @Remodel DRepair DTA, OSgn @Sprinkler @Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> (1) Furnace Change-Out with Ducting, Gas Piping from Meter to Furnace <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT ,PPL{CATION <br /> Type of Project: New _. Addn ,_Alteration Repair Type of Project: ^New Addn Alteration _- Repair <br /> #of #of #of #of <br /> List of Fixtures List of Fixtu es List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> •A/C-Air Handling Units Toilet Backflow Preventer(inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> 1 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 1 Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas <br /> Range Hood 1 `t,tY } Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> !Chemical or Water f INo.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 I am the owner,or!am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State actors Law 18.27 ROW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 0.,adt__71.e._ . / !'1. PERM/ <br /> Dolce Herrera,Administration Assistance 07102/2018 (0r4 — °I 97 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />