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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS:3003 W. CaSIC10 RCI �� �� PROPERTYTAX# P�����^ ��� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />owNeR Boeing Pho�e�E-mai� 425-301-2885 <br />Aad�e553003 W. Casino Rd. c�cYiscaceiz�PEverett, WA 98203 <br />APPLICANT: _ Owner � Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �m�5� pro��da a iener or consem rrom tna owner to ao work in tne sPace� <br />CONTRACTOR Hoffman <br />3��<�"j w- C�-S�.�o �'L�7 <br />Boeing <br />BUILDING PERMIT APPLICATION <br />L& I Lic. # Uc�li � t-'���--1b4'�'L COE Bus. Lic. # <br />V.,f/� ��?_E33 Phone/Email Zo L-4-g�%- �}-�`'7 L <br />425-301-2885 <br />PRICE OF WORK �� � z`�� u� `�� �Uc,7 <br />Existing Use of Building N�A HEAT SOURCE: <br />PropoSed Use of Building Site Utilities Gas Electric <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: k New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition Changf <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�..; c �.: c ��l �.l.l�ti2 C3u ��.,� ,,�� Ci,, 'i� 5�_1r� ►� ��fz-� 5� i�c.. cs v� t"�R- ��Sl ci �� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />A/C - air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat oum� <br />Boiler <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow �reventer <br />Drinking Fou <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this applicalion 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 slate or local law regulating construclion <br />That I am authorized by the owner of this property to perform the work for which applicalion is made and I comply with the State Contraclors Law 1827 RCW and 296.200A WAC. <br />�� <br />�) <br />�,J � . �- ` h--- �ds����- <br />Owner/Authorized Agent Signature Date (Revised 6/2012) <br />