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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 /> SITE ADDRESS:10014 12th Ave SE PROPERTY TAX#2805 1 900 1 02400 PERMIT# <br /> C , - � � � <br /> LEGAL tor new construction: snort Piausubdivision Greenfield Park Lot No.4 (attach copy of long legal description) <br /> OWNER Lennar Northwest Phone/E-mail �253)590-2205,marijke.vanstichel@lennar.com <br /> Address 12815 Canyon Rd E,Suite F CitylState/Zip Puyallup,WA 98373 <br /> APPLICANT: X Owner __Owner's Agent _Contractor COnYfBCtOf S A92flt _T2f18f1t(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Lennar Northwest L&I Lic.#LENNAN1893QG COE Bus. Lic.# <br /> Address 12815 Canyon Rd E,Suite F,Puyallup WA 98373 Phone/Email Se2 AbOV2 <br /> TENANT BUSINESS NAME CONTACT FOR PERM�T <br /> Eric LaBrie,(253)838-6113,eric.labrie@esmcivil.com <br /> Phone/E-mail <br /> BUILDING PERMIT' APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building New Single-Family Residence,Basic Plan#417B Gas X E�ectric other <br /> Building type: X Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: X New Addition Remodel Repair_T.I._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> New Single-Family Residence, Basic Plan #417B <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_�4ddn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units 3 Toilet <br /> 1 Forced air systems 2 Bathtub <br /> 4 Gas piping 4 Lavatory(wash basin) <br /> 1 Water heater 1 Shower <br /> 1 Gas fireplace 1 Kitchen sink&disposal <br /> 1 Gas range 1 Dishwasher <br /> 1 Clothes dryer 1 Clothes washer <br /> 1 Range hood Wate <br /> 4 Exhaust fan Sink(service/bar/mop/etc.) <br /> H�at 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 1827 RCW and 296200A WAC. <br /> ��.� '� (� ;�` 1� ��z <br /> Owner/Authori ed Agent Sigraature Date (Revised 6/2012J <br />