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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> 1010 E. Casino t'Zd Cvelrt?,i \A A°182-03 230 507-0030q800 Fi 505-003 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Cas cad e\R Presbyterian Outrc,t Phone/E-mail (1-125)355.-5352 / Upch rch c@ co hca F.he/ <br /> Address Lou E, Casino t2d City/State/Zip Ev xet-i-, \JA 98203 <br /> APPLICANT:_Owner - Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR pro°co l p l vn' 6 CA a,Sew et' State Lic.# City Bus.Lic.# <br /> Address qty itoTh place SC qg jg Phone/Email <br /> 0-12.6)14 4614.0///serw'ceCprol-otol plumb b=11. <br /> (.om <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Chlnrck Comm a rh3 (-avol e-A Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 1600–$4('?0-oa <br /> Existing Use of Buildings HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <br /> Building type: _Single Family —Duplex_Townhouse _Multi-Family si Commercial <br /> Type of project: New \I Addition _Remodel Repair T.I. Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _NewAddn _Alteration_Repair Type of Project: _New_Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping , Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump / Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM 1 Other: J q4 01 0 c <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp) <br /> with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 7 (PP lz4/2t5 <br /> Owned, ized Signature Date (Revised 9/2014) <br />