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41"7" PERMIT APPLICATI t <br /> BUILDII— MECHANICAL/PLUMBING/SIG <br /> II -RINKLER /DEMOLITION <br /> CITY OF EVERETT PERMIT SER <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:603 Winton Ave PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:James D Gregoire TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 603 Winton Ave <br /> cnv Everett Srrcn: WA /m 98201 <br /> OWNER PHONE:206-290-4717 (OWNER EMAIL: jim.gregoire@gmail.com <br /> CONTRACTOR NAME Bull Construction LLC <br /> CONTRACTOR ADDRESS: STREET4915 15'h DR NW <br /> CITY Tulalip Srnrr: WA zip 98271 <br /> CONTRACTOR PHONE: Eric Bergesen CONTRACTOR EMAIL: eric@bull-construction.com <br /> CONTRACTOR LICENSE#CC BULLCCL834LT: ICITY OF EVERETT BUSINESS LICENSE&684.984-207../ . ,\ <br /> PRIMARY CONTACT: OWNER XCONTRACTOR OTHER(Please Specify) U.01 Al 2©1 v) <br /> CONTACT NAME: Eric Bergesen CONTACT PHONE: Eric Bergesen 6-0 Cj , 9 0 I -6 0 Li Li <br /> CONTACT EMAIL:eric@bull-construction.com 1 <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Residence Contract Price of Work:$8,000.00 <br /> Proposed Use of Building: Residence Heat Source: X Electric <br /> Building Type: SFR-Detached X SFR-Attached Duplex Multi-Family-#of Units: Commercial Industrial <br /> Type of Project:X New <br /> DESCRIPTION OF WORK: <br /> Install new bathroom <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 Addn _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 • I Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler I Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration 1 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 /> I Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> 'Chemical or Water I 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 I am authorized by the owner of this property to perform the work for which application is made, <br /> and I omply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> ��3� � ��- x%11u-boq <br /> utd ASi <br /> Owna horiPERMIT# <br /> zed Sign ure Date (Revised 9/23/2016) <br /> 1 <br /> L <br />