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<br /> PERMIT APPLICATION W
<br /> Uri .
<br /> BUILDING I MECHANICAL I PLUMBING / SIGN /SPRINKLER/ DEMOLITION
<br /> EVERETT CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> WASHINOVON (P)425-257-8810 j FAX 425-257-8857 I(E)everetteps@everettwa.gov 1 www,everettwa.goviperrnits
<br /> (Mu*oi Mack Ink Only Plea* :1;7 ::: PlitijECT,SiltifilifitiAlAM 514.Y, .,„..:<4.,,,A,: , ",. , '
<br /> PROJECT SITE ADDRESS; (6C)il .v.„„ beech ‹..)-t, PROPERTY TAX#: Co(D 210 oci\ eK .4
<br /> LEGAL for now construction: Short Plat/subdivision Lot No. (attach copy of long legal description)
<br /> ' ' • ' •',- '' -7' '''.1:'!-,':er'"'';'''''''.1,' ":7-eFi-7,A,-- :::,.-trtigilf:Afffi, IORVAtiOXMCVM74:4-01:Vie'0104:igi4fZ-: '" '•:-:::';-44'
<br /> OWNER NAME: -Si r\f,,, ''E2f•iv,..\pvn TENANT BUSINESS NAIVIE,(CommercIaI);
<br /> OWNER MAILING ADDRESS: STREET 1,10 V*4 \ft.\'FftrY1 Ste
<br /> CrrY everet b STATE V.1481 nt' Ck.)')7CP-.
<br /> OWNER PHONE: (a—lopnc.)- ici 22 OWNER EMAIL:
<br /> CONTRACTOR NAivie:Brennan Heating
<br /> CONTRACTOR ADDRESS: s1REET4601 S 134th Pi
<br /> c ny Seattle STATE Wa ZIP 98168
<br /> CONTRACTOR PHONE:206-248-7900 CONTRACTOR emAiL:jairnie@brennanheating.com
<br /> CONTRACTOR LICENSE#(REOUIRED):BRENNHA971R9 CITY OF EVERETT BUSINESS UCENSE#(REQUIRED): 028230
<br /> PRIMARY CONTACT: 0 OWNER El CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE:206-248-7900
<br /> Jaimie How CQNTACT EMAIL:jaimie@brennanheating.com
<br /> - - ;:B".010fiNG:114.-EdiW4 ., ,4;Z:'';',-"'
<br /> Existing Use of Building: Contract Price of Work:$,..1A 14 L' _
<br /> Proposed Use of Building: Heat Source: OGas ISElectric ClOther
<br /> BUILDING USE: EISFR OTownhouse ODuplex DADU DMulti-Family-#Units: OCommercial I:Accessory Structure
<br /> Type of Project: ONew DAddition ORemodel ORepair DT.I. IDSIgn OSprinkler ODemolltion DChange of Use
<br /> DESCRIPTION OF WORK: ReckaLe- ei,•, ;e-q ,3i (, yordiec,....\ "tylczil vNie---ot polly-Tp
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> MECHANICAL PkRIVIIIT APPLICATION ‘-'-,4, ,;-: 1:41N,if,:oLitott#46ititmitiiripurioros,
<br /> Fixture Fixture Fixture Fixture
<br /> List or Fixtures List of Fixtures List of Fixtures List of Fixtures
<br /> count .,-----• - ),„„ Count Count Count
<br /> I .A/C--€t'Handling Units) Gas Piping Backliew Preventer(Inside Bldg) Shower,Tub,or Combo
<br /> Boiler -
<br /> 'Paa.19g a Clothes Washer Sink-Commercial(3-comp,prep,floor)
<br /> Clothes Dryer 1 feat Purn)SiDuctless Dishwasher Sink-Residential(kitchen,bath,bar)
<br /> Duct System(Remodel) Iiiirrig-eration Drinking Fountain Sink-Utility,laundry,mop
<br /> Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet
<br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal
<br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair
<br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/011 Water Service(behind meter)
<br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures
<br /> Gas Fireplace/Insert/Log Roof Drains Water Heater
<br /> SPRINKLER tatiPtaitESSIONISYSTEM4 .- Sewage Ejector or Sump Pump Other:
<br /> Water Suppression System -NO.orHeas
<br /> Chemical Suppression System No.of Heads
<br /> ACKNOWLEDGEMENT:!have reviewed this application and confirm the information contained herein is true end 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 firspe authorized in writing from the
<br /> Building Oft/ al before being authorized under any circumstance.I am the owner,or!am authorized by the owner of this property to perform the work for which application is made,
<br /> and!comply ith the State Contractors Law 18,27 RCW and 296.200A WAG.
<br /> ( ' ..
<br /> 0 r/Authorized Agent Signature
<br /> 16,
<br /> 2110/ 0
<br /> Date pERmiT\ti„, City of Everett Official Use Only
<br /> Mr c)--a 1 L' 06
<br /> (Revised 10/10/2018) .
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