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� <br />• <br />� <br />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 />ADDRESS: IPROPERTY TAX # <br />604 Warren Ave, Everett, WA 98201 00561901300102 <br />IT <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />John Mostrom & Cathy Woods <br />Phone/E-mail (206) 355-0896 / ho <br />�� <br />ress 604 Warren Ave �City/Stateizip Everett, WA 98201 <br />�LICANT: _ Owner � Owner's Agent � Contractor _ Contractor�S A92flt _ TBf12f1Y (must provide a letter of consent from the owner to do vrork in the <br />RACTOR Smart Energy Today, INC <br />State Lic. # SMARTET870BS Citv Bus. Lic. # 052463 <br />Address 1001 Cooper Pt Rd SW Ste.140-290 Phone/Email 360-243-2799 / ryan.f@smartenergytoday.net <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Ryan Fieldsend / 360-339-7594 / ryan.f@smartenergytoday.net <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $4960 <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric_ Other <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project New � Addition _ Remodel _ Repair _ T.I. Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />Installation of PV Solar system on a Residential Rooftop <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number # of fixtures <br />A/C — air handlinq units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ranqe <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />n <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />s <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />h basi <br />Shower <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow preventi <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />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 compl <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 olher state or local law regulating construction <br />That I am authorized by the owner of this property to perform the work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />� , 11 /19/2015 <br />Ow IAuthorized Agent Signature Date (Revised 9/2014) . <br />2 <br />