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PERMIT ��PLICATION <br />BUILDING/MECHANICAL/PLUIVI�ING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-25i-8810 FAX 425-257-8857 www.everettwa.org <br />TE ADDRESS: rROPeRrv Tax u <br />1002 Broadway Avenue, Everett, WA 98201 00385422101700 <br /># <br />0 <br />LEGAL for new construction: Short PlaUsubdivision NA Lot No. (attach copy of long legal description) <br />OWNER Amstar/Koz EvCC. LLC PnoneiE-r„a�i 206.755.1290/Joshla�kozdevelo�ment. <br />Atldress 1208 Tenth Street, #201 �Lity/State/Lip Snohomish. WA 98290 <br />APPLICANT: � Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �m�sc Pro��de a iener or �o�5e�c from ine owr,er �o do work m ine SPa�e> <br />CONTRACTOR State Lic. #�, � L'" , Eity Bus. Lic. #(j�1-��((�( i <br />Address 1010 SE Everett Mall Way, Everett, WA 98208 Phone/Email 425.609.0400/TNelson Gnklrtlev-Cole.Co <br />NA <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building SFR <br />Proposed Use of Building NA <br />Building type: � Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition Remodel Repair <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />Demolish single family residence on site. <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fix[ures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />Boiler <br />^_ _� I Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Josh Scott <br />PnoneiE-ma�i Same as Owner Information Above <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE: <br />Other <br />Multi-Family _ Commercial <br />T.I. Siqn Sprinkler X Demolition Chanqe 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 basi <br />Shower <br />Kitchen sink & dispc <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mc <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease tr� _V__ <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />inside <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 governing ihis type of work will be comp <br />with whether specifed herein or nof. The granting of a permit does not presume to give authonty to violate or cancel the provision of any other state or local law regulating consWction <br />That I am aulh�lnzed by the owner of this property to perform the work for which application is made and I comply with ihe State Contractors Law 1827 RCW and 296200A WAC. <br />� / <br />; � ; �, / �/n�� <br />��' r � � � �` %�l� �'Z���.� <br />Owner/A'LtFiorized�Agent Signature Date (Revised 4/2015) <br />1 � <br />