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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: <br />PROPERTY TAX # <br />PERMIT # <br />6101 Associated Blvd, Everett WA 98203 <br />28040100303500 <br />/� ( 5 _ e <br />LEGAL for new construction: Short Plat/subdivision <br />Lot No. (attach copy of long legal description) <br />OWNER Underwood Gartland Everett LLC <br />Phone/E-mail <br />Address 4210 132ND AVE NE <br />City/state/zip BELLEVUE, WA 98005-1115 <br />APPLICANT: Owner Owner's Agent X Contractor Contractor's Agent Tenant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR Emerald Fire LLC <br />L & I Lic. # EMERAFL980MR COE Bus. Lic. #43979 <br />Address 11021 Cramer Road KPN, Gig Harbor WA 98329 <br />Phone/Email 253-857-2056 KeithH@emeraldfirellc.co <br />TENANT BUSINESS NAME Building Permit# B 1511-020 <br />CONTACT FOR PERMIT <br />Electric Mirror <br />Keith Hillstrom <br />Phone/E-mail 253-857-2056 KeithH rLemeraldfirellc.com <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 2700.00 <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building <br />Gas_ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Multi -Family X Commercial <br />Type of project: New Addition Remodel Repair <br />_ T.I. Sign X Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />Re -Install Fire Sprinkler System under relocated Mezzanine (24 <br />Sprinklers) <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />j Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />24 Number of Heads <br />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 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 18.27 RCW and 296.200A WAC. <br />caner/A tid'Agent Signature 7 Date <br />(Revised 612012) <br />