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• • <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 />ADDRESS: IPROPERTY TAX # <br />6807 Ever�reen Way, Everett <br />P <br />for new construction: ShoR PlaUsubdivision Lot No. (attach copy of long legal description) <br />O .L. <br />OWNER Wal reens c/o Brant Heflin Phone/E-mail (847) 315-4595 /brant.heflin@walgreens.com <br />Address 106 Wilmot Road, MS #1620 City/State/Zip Deerfield, IL, 60015 <br />APPLICANT: _ Owner xOwner's Agent _ Contractor _ Contractor's Agent _ Tenant �m�st Pro��de a iener or consen� rrom �ne to do work in the space) <br />CONTRACTOR ����j (�j/t ��(p�(�� State Lic. # i -- ity Bus. Lic. # f�Fl� <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT q <br />���'C1 Ic r��� (480) 220-41��tte Zacherson/ Stantec <br />�ti Pno�e�E-ma�iAnnette.Zacherson stantec.com <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $27,504 <br />Existing Use of Building � HEAT SOURCE: <br />Proposed Use of Building Gas Electric_ <br />Building type: _ Single Family _ Duplex _Townhouse _ MulYi-Family "Commercial <br />Type of project: New Addition Remodel Repair f T.I. _ Sign _Sprinkler _Demolition Char <br />DESCRIPTION OF WORK (additiona/ space provided on the back): <br />� � - I�l��l9�ee��s <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixfures <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 um <br />Unit heater <br />Boiler <br />; Refrigeration <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Other <br />of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toifet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & dis osal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink servicelbar/mo /etc. <br />Backflow reventer <br />Urinal <br />Drinkin Fountain <br />Floor drain <br />Grease tra <br />Roof drains <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 correcL All provisions of laws and ordinances goveming this type of woric will be compi <br />with whether specified herein or not. The granting of a permit does not presume to give authorily 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 1827 RCW and 296200A WAC. <br />� � J b � I �=���� �� <br />Owner/Authorized Agent Signature � Date (Revised 9/2014) � <br />