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10/07/2015 13: 07 2065757529 STATE h+1ECHANICAL PAGE 03/03 <br /> PERMIT APPLICATION <br /> BUIWIN G/MECHANICAL/PLUMBIN G/SIGN/SPRINKLER/D EMOLIT'ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetf, WA 98201 425257-8810 FAX 425-257-8857 www.everettwg.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS_ 0,336th Ave W Bldg, B PROPERTY TAX# 28040300400800 P I # <br /> LEGAL for new construction; Short Plat/stimivision Lot No. (attach copy of long legal description) <br /> OWNER POWDERMiLL PHASE 1 LLC Phone/E-mail <br /> Address 6840 FORT DENT WAY SUITE 350 citytstaiehlp SEATTLE,WA 98188 <br /> APPLICANT. Owner Ovnlgr,^,Agent X Contractor _Contractor'z Agent _Tenant(muK wov O4aiettar or onaentf mthe oNa ert4 no wron fn Yib apace) <br /> CONTRACTOR State Mechanical L&I Lic.# STATEMC141127 COE Bus.Lic.# 030329 <br /> Address 8706 5 222nd ST Kent,WA 98031 Phone/Email 206-575-7527 stevec@statemech.net <br /> TENANT BUSINESS NAMF CONTACT FOR PERMIT <br /> — " L Phone/E-mail 206-575-7527 stevec@statemech.net <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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 /> . <br /> Typo of project: New _ A0011lon _Remodel Repair X TJ. 5( n_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(0d(1/trona/space provided on flit back): <br /> To plumb and install:4 Water closets, 4 Lays, 2 Sink&2 Hot water tank <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project New X Addn _Alteration_Repair Typo of Project; NOW Addn _Alteration_Repair <br /> Snow Number(R)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units 4 Toilet <br /> Forced airs stems Bathtub <br /> Gas plping —4 Lavato wash basin) <br /> Water heater Shower <br /> Gas fireplace 2 Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink servlcefbar/mop/etc. <br /> Heat pump l Backflow preventer <br /> Unit heater i Urinal <br /> Boller Drinking FOUntain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap. <br /> DUctin Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM l Other: <br /> Number of Heads Other: <br /> I hereby certify that I slave read and examined this ypoicotbn and know the Same to be true and correct.Air provisions of laws and prdinances governing this type of work will oe Complied <br /> with whether apecined herein or nat.The granting of a permit dove not pry�ume to give auttionty w violate or cancel the provision of any other state or local law regulating construction <br /> That i em adthohzad by the owner of this property to perform the work Por whist+application is made and I comply with the State Contractors Law 18.27 RCw and 296200A WAC. <br /> CAN194 7/31/15 <br /> Owner/Authorized Agent Signature Date (Revised 6/2072) <br />