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i <br /> "r PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/ DEMOLITION <br /> i CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> P 425-257-8810 FAX 425-257-8857 E dvai (tees } www everettwa, ov! ermits <br /> O I ( ). e3terettw .gov 9 P <br /> PROJECT SITE INFORMATION <br /> i PROJECT SITE ADDRESS: PROPERTY TAX v <br /> ( 12502 17th Ave SE 01069700001500 <br /> EGAL for new construction: Short Plat/subdivision Lot No (attach copy of long legal description) <br /> CONTACT INFORMATION; <br /> OWNER NAME: &. Dlaflfle HOfStedt TENANT NAME(If Commercial); <br /> f <br /> I OWNER MAILING ADDRESS: STREET 12502 17th Ave SE <br /> CIN EVERETT STATE WA ZIP 98203 <br /> OWNER PHONE:415 533 9159 i <br /> format,EMAIL::.rollycpa@outlook.com . <br /> .CONTRACTOR NAME MM COMFORT SYSTEMS <br /> CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE,C-200 <br /> carr REDMOND STATE WA ZIP 98052 <br /> I ,CONTRACTOR PHONE:425-881-7920 [CONTRACTOR EMAIL:permits@mmcomfortsystems.com <br /> i CONTRACTOR LICENSE#(REQUtR) „MMCOMCS85564 [CITY OF EVERETT BUSINESS LICENSE#(REQUIRED) 055,245' <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE 425-881-7920 <br /> l JENAH BARLOW <br /> i CONTACT EMAIL.permits@mmcomfortsystems.com <br /> BUILDING PERMIT APPLICATION <br /> -EXiSting Use of Building. Contract Price of Work:$ -5rCJ(.1Q <br /> ed Use of Build t g ,fiat Source: ❑Gas Electric ❑O er <br /> Building Type; ❑SFR-Detached DSFR-Attached (Duplex 0Multi-Family-#of Units:, ❑Commercial ;0Industrial <br /> Type afProject ❑New ' Addition DRemodel ❑ReEair DTA. °Sign ❑Sprinkler ODemolition ❑Change of Use <br /> DESCRIPTION OF WORK:- <br /> ADD AC <br /> EI <br /> OCIATED BUILDING PERMIT II($app)irable): <br /> MECHANICAL PERMIT APPLICATION " PLUMBING PERMIT APPLICATION <br /> 'Type of Project: _New_ Addn _Alteration _Repair Type of Project: _New. . Addn Alteration _Repair <br /> o)' t #of <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures Fixtures <br /> Afl`--:Air Ha ndling•Units Heat Pump Toilet Backflow Prevents!(Inside Bldg) <br /> Forced-Air Systtms __ Unit.Heater Bathtub Urinal <br /> -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 Ranke Ducting Dishwasher • Roof Drains <br /> °Clothes Dryer Hookups Other: Clothes Washer _ Medical Gas <br /> Range Hood Water Heater Other <br /> Exhaust Fan ,' Sink'S(ServiceJBerIMop/etc. Other: <br /> SPRINKLER!SUPPRESSION SYSTEM <br /> (Number 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 I 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 1 11,27 RCW and 296.200A WAC <br /> Grof Everett Official Use Only <br /> yy\PERM( <br /> ' d Sig re Date Rath at.'ft/4rli201 <br />