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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/ PLUMBING/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 a Buck �kr6 iry Ply lsej; PRIbJLC' IT1 INFOR1iilA'iIION ,w <br /> PROJECT SITE ADDRESS: 4320 Ridgemont Dr, Everett 98203 PROPERTY TAX#: 00555600002200 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT`INFORMATION <br /> OWNER NAME: Jason Bontrager TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET (same as above) <br /> CITY STATE ZIP <br /> OWNER PHONE: 425.315.5336 OWNER EMAIL: bonty@aol.com <br /> CONTRACTOR NAME: N/A !.(912&(/' <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: Qi OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425.315.5336 <br /> Jason Bontrager CONTACT EMAIL: bonty@ - . 0 <br /> BUILDING PERMIT APPL1(CATION <br /> Existing Use of Building: SF Residence Contract Price of Work:$60,000 <br /> Proposed Use of Building:SF Residence Heat Source: ❑Gas fnEle c ❑Other <br /> Building Type: CASFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition I2Remodel ❑Repair CIT.!. OSign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> Finish/remodel basement <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATIONII PLU1'MIIBIN;G'l'ERMIT-APPLICATION <br /> Type of Project: _New _ Addn Alteration Repair / Type of Project: ,.New _Addn _Alteration _R .it <br /> #of List of Fixtures #of List of F'• ures #of List of Fixtures #of Lis •f Fixtu - <br /> Fixtures Fixtures Fixtures Fixtures <br /> A/C—Air Handling Units Hee -ump Toilet Backlit ' Prevent- (Inside Bldg) <br /> Forced Air Systems it Heater Bathtub Ur <br /> 4. <br /> Gas Piping Boiler Lavatory(Wash Basin) eri • Fo tain <br /> Water Heater R igeration Shower Flo. II <br /> Gas Fireplace ood Stove Kitchen Sink&Disposal Grea e rap <br /> Gas Range Ducting Dishwasher Row''rS rains <br /> Clothes Dryer Hook .s Other: Clothes Washer edical Gas <br /> Range Hood • Water Heater , Other: <br /> Exhaust Fan Sink(Se . e/Bar/Mo.`,.. . I ' Other: <br /> SPRIN. ° R I-SUPPRESSION SYSTEM <br /> Chemical or Water ' 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!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 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 6/15/a igO Dom, <br /> (112) <br /> Owner/Authorized A nt Signatur Date (Revised 9/23/2016) <br />