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PERMIT APPLICATILAU
<br /> BUILDING / MECHANICAL I PLUMBING I SIGN /SPRINKLER I DEMOLITION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> iP)425-257-8810 I FAX 425-2Fi7-8857 I(E)overetteps@everettm gay I v,...A4./evorettwa flovipertutts
<br /> I(Blue or Black Ink Only Please) PROJECT SITE,INPO#MATION ''''''' - ' •
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<br /> PROJECT$ITE ADDRESS: •ti 3 'i' PROPERTY TAX#:001/4458€,i og oo i 0
<br /> 'LEGAL for new conetruaon: Short Platisabdwtsion Lot No, (attach copy of long legal description)
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<br /> ' CONTACT INFORMATION
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<br /> OWNER NAME: t ()Pr\ 3a, C.,2.. or\ TENANT NAME(If Commercial):
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<br /> OWNER MAILING ADDRESS: STREET 4,Sk4 4,
<br /> S.i ,r ti in
<br /> cire ev,,,,,...4
<br /> .4A.) 0- ,,, CP.5.00k
<br /> OWNER PHONE: 44',g5 - -1-40,0 - I t9'43 OWNER EMAIL:
<br /> rcCONTRACTOR Brennan Heating
<br /> , ONTRACTOR ADDRESS: s'ameT 4601 S 134th Pi
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<br /> , cm, Seattle simf Wa ,,,,,, zr 98168
<br /> CONTRACTOR PHONE: 206-248-7900 CONTRACTOR EMAIL: Jaimie@brennanheating.com
<br /> ,CONTRACTOR LICENSE ll(REOLIFM: BRENNHA971R9 CITY OP EVERETT austNEsS LiCENSE ittREOUIREDj: 028230
<br /> PRIMARY CONTACT; 0 OWNER p CONTRACTOR 0 OTHER(Please Specify) —
<br /> !CONTACT NAME: CONTACT PHONE; 206-248-7900
<br /> I Jatrnie How CONTACTEMAIL: dairrie .,..
<br /> ($12# - a eating.corn
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<br /> BUILDING PERMIT APPLICATION/
<br /> Existing Use of Buildinv. Contract Price of We: :. Toi toli ts '
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<br /> Proposed Use of Be4in.: ..''P I' Heat Source: 19 0Electric 0 ether.
<br /> Buildin+T pc; Z SFR-Detachee OSFR-Atioched ODuflex St Multi-Famil -#of Units: , 0Cof merciat Dtndustriaf
<br /> iType of Project: ONew ClAddition ORomodel ORepair Ci TA, OSign OSprInktor , III Demolithi 0Change of Use
<br /> D RIPTION OF WORK: )12I
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<br /> 32A-
<br /> ASSOCIATED BUILDING PERMIT#(if applicable)'
<br /> MECHANICAL PERMIT APPLICATION, - - ,:;?...•tet , P' P L U tilWO.40*,,,' ,t t AtP,t.Kt*
<br /> i Type of Project: N.vi Arlon Alteration Repair Type of Project: New Addn Alteration , Repair
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<br /> #of #of #of itof
<br /> Fixtures
<br /> List of Fixtwos List of Fixtures List of Fixtures Fit List of Fixtures
<br /> Fixtures Fixture_
<br /> tuures
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<br /> –A/C–Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg)
<br /> Forced Air Systems Unit Heater Bathtub Urinal
<br /> Gas Piping Boder Lavatory(Wash Basin) Drinking Fountain
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<br /> Water Heater - ,Refrigeration Shower Floor Drain
<br /> ,Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap
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<br /> Gas Range Ducting Dishwasher Roof Drains
<br /> Clothes Dryer Hookups Other: Clothes Washer Medical Gas
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<br /> Range Hood Water Healer Other:
<br /> Exhaust Fan Sink(Sorvice/BartMep/olc.) Other:
<br /> SPRINKLER / SUPPRESSI ,STEM
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<br /> i Chemical or Water 1No.of Heads
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<br /> ACKNOWLEDGEMENT:I have reviewed this application end C-011firM the information contained herein is true and correct Work done pursuant to this permit must comply with
<br /> current to-dealt state,into local lam The granting of a permit only authorizes approved mark and no deviations therefrom.Deviations mist first be authorized in writing from the
<br /> &Wing Officio,before being authorized ander any ttactimstentv.I inn the owner,or I rim authorized by the owner of this maw*to perform the work for which application is made,
<br /> and > :>iy with the State Contractors Law 18.27 RCW arid 296.200A WAC,
<br /> 1 q City of cEverettlitteinal Use 0rey
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<br /> II PERIV0
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<br /> 0 • Authorized Agent Signature Date (Revised 9/23/2016)
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