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�ERMIT APPLICATIO� <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 />SITE ADDRESS: PROPERTY TAx # PERMIT # <br />1122 75th Street SW 28041200305000 ��w ��07 P- <br />LEGAL for new construction: Short PlaUsubdivision (attached ) Lot No. (attach copy of long legal description) <br />OWNER Canyon Creek Churc <br />Address 1122 75th Street SW <br />CANT: _ Owner X Owner's Agent <br />Phone/E-mail <br />City/State/Zip Everett, WA 98203 <br />Contractor _ Contractor�S A92flt _ T2tl8f1l (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR TCI inc. General Contractors L& I Lic. # TCIIN**07700 COE Bus. Lic. # 043225 <br />Address 13500 Bel-Red Road, #9 Bellevue 98005 Phone/Email (425) 454 5310 <br />Canyon Creek Church <br />BUILDING PERMIT APPLICATION <br />liV1Y1Mli1 ��R��R,.,,, Lee Kirk, Lee KirkArchitecture <br />Phone/E-mail Lee@Lee-Kirk.com <br />CONTRACT PRICE OF WORK $ 30,000 <br />Existing Use of Building Church HEAT SOURCE: <br />Proposed Use of Building CilUl"Cil Gas� Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair � T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additiona� space provided on the back) : <br />Misc work done without permit (demo partitions at Cafe, Classroom 231; increased <br />occupant load, enlarge platform, removed ceiling at Worship Center) <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number !#) of fixtures <br />SPRIN <br />fvt; — air nanaimg un <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />basin <br />Shower <br />Kitchen sink & disp� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify 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 s cified 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 auth zed by the owner of is perty 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 />� 7/22/14 <br />�l� <br />Owner/Authorized Agent Signature Date (Revised 6/2012) <br />