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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 /> SITE ADDRESS: 6015 Kenwood Dr PR 006OPER21600200400 M T <br /> LEGAL for new construction: Short Plat/subdivisionFLINTSTONF,TERRACE,BLK 002 Lot No. 4 (attach copy of long legal description) <br /> OWNER Darwin &Donna Radovich Phone/E-mail 206-719-2589 or 425-328-8760 wtow'. <br /> Address 5327 157TH PL SW City/State/Zip EDMONDS, WA 98026 yV; 11,5�N2- <br /> APPLICANT: Owner X Owner's Agent Contractor Contractor's Agent Tenant(must proviidd�ela letter of consent from the owner to do work in the space) <br /> CONTRACTOR -T-Baw , �l GA'"1 State Lic.#L'�t ��) l.(J "I� (� City Bus. Lic.# <br /> Address ' ` 1'.) 1 fes, Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 206-456-3071 TBartley@fossatti.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK-$,— <br /> Existing <br /> ORK_$,—Existing Use of Building SFR HEAT SOURCE: <br /> Proposed Use of Building SFR Gas Electric Other <br /> Building type: _Single Family X_Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project: New X Addition Remodel —Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Permit existing carport <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 airs stems 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 Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> I <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> l <br /> Ducting 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 am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> {� ( , <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br />