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morn® PERMIT APPLICATIOi <br /> 11 <br /> BUILDING/ MECHANICAL I PLUMBING I SIGN / SPRINKLER I DEMOLITION <br /> E V E R E T TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps©everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION MFS ,.:k — <br /> PROJECT SITE ADDRESS: .� o l Ql t..,-.)-4,..\- yr\ or� p,v--�. <br /> PROPERTY TAX#: 0041 i idol ccq oo <br /> LEGAL for now construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> — <br /> y <br /> CONTAC 9[1F <br /> OWNER NAME: 4M- t„,_,\,.•C. .(1,S\;,,t-\ TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET eT _,¢ <br /> 01T? STATE Z. <br /> OWNER PHONE:4 j, , r , ... OWNER EMAIL: <br /> CONTRACTOR NAME:Brennan Heating <br /> CONTRACTOR ADDRESS: sTruEr4001 S 134th PI <br /> erre Seattle STATE Wa zip 98168 <br /> CONTRACTOR PHONE:206-248-7900 CONTRACTOR EMAIL:jaimie©brennanheating.Com <br /> CONTRACTOR LICENSE#(REQUIRED):BRENNHA97I R9 'cry OF EVERETT BUSINESS LICENSE ti(REQUIRED): 028230 <br /> PRIMARY CONTACT: 0 OWNER El CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-248-7900 <br /> Jaimie How CONTACT EMAIL:jaimie@brennanheating.com <br /> BUILDING`IN1 I TIOI+I '. <br /> Existing Use of Building; ,p Contract Price of Work:$ <br /> Proposed Use of Building: Heat Source: { Gas C EI`octric DOtherppm <br /> BUILDING USE: DR, DTownhousu [Duplex DADU °Multi-Family-#Units: ❑Commercial DAccossor)!Structure; <br /> Type of Project: :New CAddition E]Remodol CJRepair IE.t:I. DSign DSprinkler' ❑Demolition DChan e of Use <br /> DESCRIPTION OF WORK: I n t k t . tto -%N,.....,,,,,.. ( ;.tie c_ cJ 3 r�7 <br /> ASSOCIATED BUILDING PERMIT II(if applicable): <br /> MECHANICAL PERMIT APPLICATION - RF PLUMBING PERMIT:APPLICATION <br /> Fixture} few* Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> NC-Air Handling Units Gas Piping Backtlow Preventer(Inside Bldg) Shower.Tub,or Combo <br /> Boiler Gas Range _ c, Washer Sink-Commercial(3-comp,prop,lloor) <br /> Clothes Dryer I Heat Pumpt�Ducttess7 Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Typo I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Typo II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil - Water Service(behind motor) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER I SUPPRESSION,SYSTEM Sewage Elector orSump Pump Other: <br /> Water Suppression System I IN°,of Heads <br /> Chemical Suppression System Iwo.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained heroin is true and correct.Work done pursuant to this permit must comply with <br /> current fedtrral,stale,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be outhonxod in wntirrg(Mtn the <br /> Building Official before being authorized under any circumstance.t am tho owner,orf am authorized by rho owner of this property to perform the work for which application is made, <br /> and f cora with Me State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> --�/1Jj q . PESO 7_,_- � <br /> nor/Authorized Agent Signature Date (Revised 10/101016) <br />