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�c5o22� <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLER/D�MCLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everetlwa.or <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 3 Z� � �S <br /> SITEADDRESS: PNOPfRTYTN(M PE MITM <br /> 5012 23RD AVE W 00644500001500 � ( <br /> LEGAL br new mnslruci�on: Short PlaUsubdivivon Lat No._ (attac�copy ol long legal descnptian) <br /> OWNER NORIKO YASUllA PhonrlE�mail 408-746-9655 <br /> aaress 5012 23RD AVE W Ciq151ate/Zip EVEREI'T, WA 98203 <br /> APPLICANT: Owner OwnelsAgent X Coniractor ContractoYSAqenl TenOnl�mustyo.tleebrsraim�uomrtomnewnamaowrninme�po� <br /> CONrtucTOR il1M COMFORT SYSTEMS L&I Lic.# MMCOMMC934B4 Coe eus.�ia a <br /> daress 18103 NE 68TH ST�C-200 REDMOND 9R052 Phone/Email 425-881-7920 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> JANET CHELGREN <br /> Phnnrl E�mail 425-881-7920 <br /> BUILDING PERMIT APPLICATIOH CONrttnC7 PRICE oF WORK <br /> Existing Use of Buitding HEAT SOURCE: <br /> Proposed Use ol Building Gas_ Eleclnc_ Olher_ <br /> Buildmg type: X Single Family _Duplez_Townhouse _Multi-Family _Commercial <br /> T pe o1 pro'ect: New Addition Remodel Re air T.I. Si n_S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(adtlilional space proviCeo on 1he bacA): <br /> RL'PLACE EXISIT[NG FURNACE WI7'tt NEW, LIKE FOR LIKE AND WSTALL CO1L POR PUTURE <br /> COOLING <br /> MECHANICAL PERM APPLICATION P;LUMBING PERMIT APP�ICATION <br /> Type ol Pro�ect: _New_Adtln Alteration_Repalr Type ot ProJect: _New_AdAn _Alterellon_Repalr <br /> SAow Number(N1 0!�irfures Show NumUcr(a)o!/iirtwes <br /> A/C—air handling units Toile! <br /> Forced air s stems Bathtub <br /> Gas pipin Lavato (wash basin) <br /> Waler heater Shower <br /> Gas fie lace Kitchen sink 8 disposal <br /> Gas ran e Dishwasher <br /> Clothes dryer Clothes washer <br /> Ran e hood Water heater <br /> Exhaus�'an Sink(servicelbar/mo /etc.) <br /> Heat pumv Backllow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Founlain <br /> Refrigeralion Floor drain <br /> Woodslove �rcase ira <br /> Ductin Rool drains _ <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Olher: <br /> Number of Heads Olher� <br /> I hcreby mnAy Nal I hme rc nn�CetmmeE Nu:pplictinn nnE know I�c Sdmc m Ge Ime nna mrtetl.NI pmvivonf ol pws an0 oramann!�BavemmB mu lyye al woA wti be mmpLeA <br /> vM wireNcr fpcahca hem p10DI 111C QqNip(J O(l pClTi�AM)OOI OT.SUII�C�f1 QNC:IUUOIII)'IO NOLIIC Of WpRINC p10N5100 0I011Y 0U1C1]L]IC OI IOLII L1W fCQYLl�NO fnO51pIq100 <br /> Tlml l mm�uNnnreJ bY� ner ol Nu pmperty to Perinrm I�c waM br wtuGi npP��n ie m,ae nn�I mmpN w�b V�c Slaie Comndo�e I:nv 19 71 RCW nn�19fi.2004 WAC <br /> � 2' 1 � <br /> 0 ¢e Agent Signature� Dale (RewseO N20i7) <br />