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� � <br />PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBINGISIGNISPRINKLER/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 />E ADDRESS: <br />PROPERTY TAX it <br />L for new construction: ShoR PlaUsubdivision Lot No. (attach copy of long legal description) <br />ER MCCARTY RALPH J FAMILY LP �Phone/E-mail <br />►�Y��c�/_\'l��L'i]:7 <br />EVERETT WA 98203 <br />APPLICANT: _ Owner _ Owner's Agent X Contractor _ Contractor's Agent _ Tenant �m�5c P�o��ae a iBn�� or co�se�� r�om ine o�er a ao work �� �ne SPace� <br />CONTRACTOR LAKERIDGE PLUMBING & MEC State Lic. #LAKERPM099RK City Bus. Lic. # 024220 <br />Address 13508 NE 124TH ST KIRKLAND WA. 98034 Phone/Email 425-827-9262 <br />EVERETT CLINIC PAIN CENTER <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Proposed Use of Building HEALTH CLINIC <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition Remodel Repair <br />DESCRIPTION OF WORK (additiona� space provided on the back) : <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Shaw Number # of fixtures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas range <br />Glothes drye <br />Ranqe hood <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />DuctinQ <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Dean Fitzsimmons 425-827-9262 <br />Phone/E-mail deanf@lakeridgeplumbing.com <br />CONTRACT PRICE OF WORK 47000.00 <br />Multi-Family _ Commercial <br />XT.I. Siqn Sprinkler Demolition Chanae of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New �Addn �Alteration _Repair <br />Show Number (#) of iixtures <br />Toilet <br />Bathtub <br />^ Lavatory�wash basin�_ <br />Shower <br />Kitchen sink & disposal_ <br />Dishwasher <br />Clothes washer <br />Sink (service/barlmopletc.; <br />Backflow preventer (inside <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certi(y lhat I ha,:�e 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 compi <br />with whether specife:� hr�rein or noL The granting of a permit does nol presume to give authority to violale or cancel the provision of any other state or local law regidating construclion <br />That I am ��ithunzed. by t e owner of this propeRy to pertorm the work for which apptication is made and I comply with the State Contraclors Law 1827 RCW and 296.200A WAC. <br />I <br />i� � _ _ <br />i, ; � � � _ <br />Owner/Authorized /�gent Signature � Date (Revised 4/2015) <br />9../ � �C� � 1.� %'"� <br />