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08/24/2018 13:31 #3617 P. 001/001 <br /> PERMIT APPLICATION <br /> e1,11:—A--- BUILDING I MECHANICAL I PLUMBING/SIGN I SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everottepsc)everettwa-gov 1 www.everettwa-gov/permits <br /> (Blue.air BiacK lIk'eInIy:PI )..' ....-..••:',...s.. "..PROJECTSI-Tt:MNFORMATION-: .• .• • •. .• <br /> PROJECT SITE ADDRESS:2412 MAPLE ST PROPERTY TAX#: <br /> LEGAL for new construction; Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> : '1 ';CON*Aer INFORMATION...::.:.. .:. •.. .:. .' • . . . - . . <br /> OWNER NAME: MARILYN ROSEN BU RG TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: 425.258.4940 OWNER EMAIL; <br /> CONTRACTOR NAME: EYLANDER SALES &SERVICE <br /> CONTRACTOR ADDRESS: STREET 3601 EVERETT AVE <br /> city EVERETTSTATE WA Yip 98201 <br /> _ <br /> CONTRACTOR PHONE: 425.259.2161 _ !CONTRACTOR EMAIL: - <br /> CONTRACTOR LICENSE#(REOUIRED): EYLANSSO42K2 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):016363 <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR Ireil OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425.231.2275 <br /> JOHN OVERHOT PUMP CONTACT EMAIL: <br /> ,. . ,' '..:. :'':aUI :1nNIG:'PEIRMI^ -APPLICATiQN...` ' '.':.: ,.. ; •• ... <br /> Existing Use of Building:ADU Contract Price of Work:$1200 r� <br /> Proposed Use of Building:MORE ADU Heat Source: ❑Gas la Electric ❑Other <br /> Building Type: I:ISFR-Detached DSFR-Attached ❑Duplex OMulti-Family-#of Units: Commercial Ijlndustrial <br /> Type of Project: ❑New ❑Addition ❑Remodel ❑Repair CIT.!. ❑Sign C]Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: ; tilDUCTLE � HEAT PUMP <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> oMLCMIANICAI-;:PERMIT..APPLICATION;.`.':�. ''..,... .,....;', ;-:• PLUMWPIC PERMIT.'APPLICATION : -: :.:. :.' :::. <br /> Type of Project: _Now_ Addn _Alteration _Repair Type of Project: New _Addn AlterationRepair <br /> Fixtures list of I rtutl9s Fixtures _ Fixtures pi <br /> of Fixtures Fixtures List of Fixtures <br /> A/C—Air Handling Units 1 � pi 1 Toilet 1 Backflow Preventer(Inside BIN) _ <br /> I Air Systems 1 Unit Heater I Bathtub 1 Urinal <br /> Gas Pipin 1 Boiler ( Lavatory(Wash Basin) 1 ~Drinking Fountain <br /> Water Heater 1 Refrigeration I . - Shower 1 Floor Drain <br /> _ <br /> 1 Gas Fireplace 1 Wood Stove 1 Kitchen Sink&Disposal 1 Grease Trap <br /> 1 Gas Range 1 Ducting 1 Dishwasher 1 Roof Drains <br /> 1 Clothes Dryer Hookups 1 Other: 1 Clothes Washer 1 Medical Gas <br /> 1 Range Hood 1 1 Water Heater 1 Other: <br /> 1 Exhaust Fan 1 _ 1 Sink(ServioeiBarlMop/etc.) 1 Other: <br /> 1 1 1 <br /> OP.RitiKteiCilnIPPRESSiON'SYSTem•.: ;'.:: •.;: 1 1 . <br /> 1 [Chemical or Water I1 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 wilting from the <br /> Building Official.Mia 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 coin• ;h the Slate Contractors Law*27 PCW and 208.200A WAC <br /> / <br /> City of Everett Official Use Only <br /> // y /f " ' ' I �.-601 <br /> 0 er/Authorized Agent Signature is (Revised 9/233/2/01 ) <br />