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PERMIT APPLICATION <br /> BUILDING/h�ECHANICAL/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 /> � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: 1 2th Dr SE PROPERTY TAx# P�RMIT# <br /> 0 5 Y c� �Ic�z4� , �° �-C'��C� <br /> LEGAL for new construction: Short Plat�subdivision Greenfield Park Lot No 5S (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 City/State/Zip Puyallup,WA 98373 <br /> APPLICANT: X Owner __Owner's Agent _Contractor _Contractor's Agent _Tenant�m�st P�o��de a iene�or consent r�om ine owne�to do wo�k�n ine space> <br /> CONTRAC70R Lennar Northwest L&I Lic.#LENNAN1893QG COE Bus. Lic.# <br /> Address 12815 Canyon Rd E_,Suite F,Puyallup WA 98373 Phone/Emaii See Above <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <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 415�3 �as X Electric ocner <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 WORfC(additional space provided on the back): <br /> ��� S�^,t�t C— �o�nw;`� �����E'nc�� �y�s•� �[�...n �l�"� e��J�+.j'�n � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _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 /> Ga;s piping 4 Lavatory(wash basin) <br /> 1 Water heater 1 Shower <br /> 1 Gas fireplace 1 Kitchen sink&disposal <br /> 1 Ga:s range 1 Dishwasher <br /> 1 Clothes dryer 1 Clothes washer <br /> 1 Range hood <br /> 5 Exhaust fan Sink(service/bar/mopletc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Duc:ting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Nurnber of Heads Other: <br /> I hereby certify that I have read and e�amined this application and know the same to be true and correct.All provisions of laws and ordinances goveming 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 /> -�� __.. / <br /> �� �� <- � �� <br /> �;�,•g� ! '���i�2 1� Z- <br /> OwnerlAuthorized Agent Signai:ure Date (Revised 6/2012) <br />