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• <br /> 2e�� .q 192 �� ` <br /> PERMIT APPLICATIO g . <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# P RMIT# <br /> 6101 Associated Blvd, Building A 28040100303500 15 05--OO <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Underwood Gartlaverett, LLC Phone/E-mail 425.881.2113 <br /> Address PO Box 3513 City/State/zip Bellevue, WA 98203 <br /> APPLICANT:_Owner X Owner's,( Agent _Contractor( —Contractor's Agent Tenant(must proviprovidea letter of consent from the owner to do work in the space) <br /> CONTRACTOR )��� `�� � \L'� 2 State Lic.# ��Uc�1 V ,1J ii) �� <br /> City Bus.Lic.# 0 1 <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Electric Mirror SynThesis PLLC - John Llacun, <br /> Phone/E-mail 425.646.181 8/jo• . _cuna@synth Ilc.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I I 1 I <br /> Existing Use of Building New Construction HEAT SOURCE: <br /> Proposed Use of Building Fabrication of glass products Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair x T.I. Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Tenant Improvement to include partitions and finishes for new offices, restrooms <br /> and manufacturing areas. The building shell permit number is B1502-026. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _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 I Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting I Roof drains <br /> Other ( Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <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 • onz=d by the.i ner of this property to perform the wo for which ap lication is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. 2— <br /> 1 r U n 0 � 7 cz, <br /> O . e Authorized •g�nt�gnature Date t (Revised 4/2015) <br /> , <br /> ffev/ wrzi ,? c� � �( I 40Z 3f�- krB 6-(5-15 <br /> David Gu r+Lohc( 2/J O.34 SO <br />