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01114Err PERMIT APPLICATION <br /> BUILDING / MECHANICAL / PLUMBING I SIGN / SPRINKLER I DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I .www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 1523 132nd St SE Suite B1 Everett WA 98208 PROPERTY TAX#: 28053000406300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: oLYMPIC GROWTH NORTH LLC TENANT NAME(If Commercial): HealthyFoot Massage <br /> OWNER MAILING ADDRESS: STREET 3473 Nw Lowell St <br /> CITY Silverdale STATE WA ZIP 98783 <br /> OWNER PHONE: OWNER EMAIL: info@uniformplumbingco,com <br /> CONTRACTOR NAME: Uniform Plumbing Company,LLC <br /> CONTRACTOR ADDRESS: STREET PO Box 720 <br /> CITY Milton STATE WA ZIP 98354 <br /> CONTRACTOR PHONE: 253-571-8158 CONTRACTOR EMAIL: info@uniformplubmingco.com 1 ' <br /> OA- <br /> CONTRACTOR LICENSE#(REQUIRED): UNIFOPC932BS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 268280 <br /> PRIMARY CONTACT: ❑OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Ermilo DeLeon CONTACT PHONE: 253-571-8158 <br /> CONTACT EMAIL: info@uniformplumbingco.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: ( ,,'Thi. rQ 1( (d f - i,if po,L(4 (J (- ,Contract Price of Work:$ lb � <br /> Proposed Use of Building: )'"D-`jl )'�i\,Lt.,Sc.a 5( 3 Heat Source: ❑Gas ❑Electric ❑Other <br /> Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units' `Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ,,;, Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <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 /> NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler 1 Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration 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: 1 Clothes Washer *Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.: *Other: <br /> SPRINKLER/ SUPPRESSION SYSTEM <br /> Chemical or Water I 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 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 comply with the State Contractors Law 16 27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> ti PERMIT# <br /> Owner/AArthor,o'd Ag Signature Ddte (Revised 9/23/2016) <br />