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l <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN I SPRINKLER I DEMOLITION <br /> 401,4.410 -1- CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> 1 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps©everettwa.gov I www,eVeretevegoviperniits: <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: <br /> 10012 27th Dr SE � 00762300003300... <br /> s LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of long legal description) <br /> CONTACT INFORMATION.. <br /> OWNER NAME:Eloisa Bustos TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 10012 27th Dr SE <br /> CITY EVERETT STATE <br /> WA _ z�? 98208 <br /> OWNER PHONE:425 263 1551OWNER EMAIL: <br /> 1 CONTRACTOR NAME: MM COMFORT SYSTEMS <br /> CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE, C-200 <br /> CITY REDMOND STATE WA ZIP 98052 <br /> CONTRACTOR PHONE:425-881-7920 !CONTRACTOR EMAIL:permits@mmcomfortsystems.com <br /> CONTRACTOftLICENSE AR QUIP Et}).MMCOMCS85564 CITY OF EVERETT BUSINESS LICENSE tiotEQUIRE <br /> PRIMARY CONTACT: CI OWNER '',00kTRAO OR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-881-7920 <br /> J E NAH BARLOWAll <br /> CONTACT EMAIL:permits@mmcomfortsystems.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Contract Price of Work,.$4500 <br /> Proposed Use of Building: Heat Source: ❑Gas 7,klectric DOther <br /> Building Type: ❑SFR-Der FR-Attached DDttples 0Mul0-Famdly=4 of Units, ❑Commercial ❑Industrial <br /> Type of Project ❑New do.._'=dition ❑Remodel 'C Repair ❑T.I. ❑Sign t Sprinkler DDemolition ❑Change of Use <br /> DEscAlnlON OF WOR <br /> single head ductless <br /> ASSOCIATED BUILDING PERMIT#(if tiicceble) <br /> MECHANICAL PERMIT APPLICATION" PLUMBING PERMIT APPLICATION <br /> -Type of Project: _New_ Addn Alteration Repair Type of Project: _New _Addn _Alteration _Repair <br /> Fixtures <br /> List of Fixtures Fixtures List of Fixtures Fixtures. List of Fixtures Fixtures List of Fixtures <br /> NC—Air Hand(in(,Units. . i Heat Pump ' Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air +�- Unit Heater Bath...tub `Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> :Gas Fireplace Wood Stove <br /> Kitchen Sink 4 Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Ho ops -Other: Clothes Washer Medical Gas <br /> Range Hood ` Water Heater Other: <br /> Exhaust Fan` ' ink(Service/Bar/Mop/etc. Other: <br /> SPRINKLER I SUPPRESSION SYSTEM <br /> 'Number of Hems . .A. <br /> . : . <br /> .......... <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: e'/,,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 Off r.;.before being authorized under any circumstance..I am the owner,ort am authorized by the owner of this property to perform the work for which application is made, <br /> and I cf: ,4 l the State Contractors Law 18.27 RCW and 296,200A WAG,. <br /> Cityof.Everett Official Use u_iOnly:.: <br /> ., 1PEo <br /> R <br /> - <br /> 1/30/2019 <br /> Owner tette ° Agent Signature Date w ?f1101 <br /> :tl#) <br />