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� <br />� zd�s a2� <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ITE ADDRESS: PROPERTY TAX # PERMIT # C <br />10116 27TH DR SE 007623000002900 d1�/� I S� �i �� 1 <br />�L for new construction: Short Plat/subdivision <br />ER MONNY DAKE <br />.� 10116 27TH DR SE <br />PPLICANT: _ Owner _ Owner's Agent X Contractor <br />Lot No. (attach copy of long legal description) <br />E-mail 503-804-5812 <br />ICity/State/Zip EVERETT, WA 98208 <br />COf1tf8CtOf�S A90�1 _ TBflBflf (must provide a lelter of consent from the ovmer to do vrork in the space) <br />coNTw�croR MM COMFORT SYSTEMS L& I Lic. # MMCOMMC934B4 coE Bus. �ic. # <br />o�,��,�� 18103 NE 68TH ST, C-200 REDMOND 98052 Phone/Email 425-881-7920 <br />BUILDING PERMIT APPLICATION <br />CONTACT FOR PERMIT <br />JANET CHELGREN <br />Phone/E-mail 425-881-7920 <br />CONTRACT PRICE OF WORK o�. � O � <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: X Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project New Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />REPLACE GAS FURNACE WITH NEW, LIKE FOR LIKE <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration y Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />( Forced air systems <br />Gas piping <br />Water heater <br />Gas fireolace <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />LER/SUPPRESSI <br />Number of Heads <br />HEAT SOURCE: <br />Electric Other <br />of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteretion _Repair <br />Show Number (#) of fixfures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8� disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <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 goveming this rype of woric will be complied <br />with whether specified herei o noL The granting of a permit does nol presume to give authonty lo violate or cancel the provision of any other state or local law regulating construction <br />That I am au orized by th ow er of this pr rty to perform the work for which application is made and I comply wAh the State Conlractors Law 1827 RCW and 296200A WAC. <br />C�\ ; �., ,� � <br />� /� � � ) � ` �, � `� <br />Agent Signature <br />(Revised 6/2012) <br />