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• • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES OR <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 /> SITE�jQ8gF forida Dr Everett WA 98203 PR� 9T� 00701901 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Vonda King Phone/E-mail 425-218-3882 <br /> Address 8012 Florida Dr Everett WA 98203 City/State/Zip Everett, WA 98201 <br /> APPLICANT: Owner _Owner's Agent Xcontractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to doW6;?" space) <br /> CONTRACTOR Andgar Corporation L&ILic.# 336, 680-00 COEBus. Lic. 24869 <br /> Address PO Boox 27008 Salashan Pkwy A102 Phone/Email 360-366-9900 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Dale Van Rooyen 360-366-9900 <br /> Phone/E-mail dalevr@andgar . com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building Residence HEAT SOURCE: <br /> Proposed Use of Building Residence Gas_ Electric_ Other_ <br /> Building type: X Single Family Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project New _Addition _Remodel X Repair T.I. Sign_Sprinkler_Demolition —Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <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 air systems 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 <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <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 complied <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 /> Marla J Ras ke Digitally signed <br /> _ :by Marla J Raske 09/06/2016 <br /> Owner/Authorized Agent Signature Date (Revised 6/2012) <br />