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�ERMIT /�►PPLICATIU� <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMC�LITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> �. i y-/� <br /> SITEADORESS:EOOO 23fd DfIV2 W@St PROPERTVTAXM P RMIT <br /> fl �D�-Ol6 <br /> LEGAL ior new constructian: Shon PiaVsuOdiv�sion Lot No. (allach copy o�long legal desc�ption) <br /> OWNER T8d9UC Pno�e,�-m�,, knelson@hermanson.com <br /> Aaa«�5 660G Mirrill Creek PKWY Suite 204 CitylStatclZip Everett, WA 98204 <br /> APPLICANT: Cwner Owner'sAgenl �ConVactor Conlractor'sAgenl Tenanl��.uic�o.m�•:�i�m�•�wco.�z�mi�omo-�•o+.n��,��eo+v�w��mesw�el <br /> coNrRncroR Hermanson Company State Uc p HERMACL0056J c�ry e�s u�. tt <br /> AGdress 1221 2nd Avenue N Kent, WA 98032 PhonelE,na��206-963-5097 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Teague Kaylene Nelson <br /> Pho�e,E-ma;, 206-963-5097 knelson@hermanson.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE Of WORK $91,391 .00 <br /> Exislmg Use of Building Commercial HEAT SOURCE�. <br /> Proposed Use o1 Butlding NO CF18flq@ Gas E�ectnc ✓ Othcr <br /> Buildmgrype� �SingleFamiiy❑_Du IezaTownhouse �Mulli-ramily ✓ Commercial <br /> l e of rO�ecC New Addiiion � Remodel Re air ✓ T.I. Si n S rmkler Demolilion Chan e of Use <br /> DESCRIPTION OF WORK(add�tm�ai space piooided on�ne back) <br /> Provide and install two west vent tie ins, Demo 9 fixtures and water cut and cap. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New ddn Alteralion epair Type of Project: New AdEn ✓ Altera[ion❑Repair <br /> ShowNumber p o/firfures ShowNum6er q olfrxtures <br /> A/C—air handlin umts 7oile� <br /> Forcedairs s�ems Ba1hWb <br /> Gas i in Lava�o wash basin <br /> Water heale� Shower <br /> Gas firc lace Kitchen sink 8 dis osal <br /> Gasran e Dishwasher <br /> Ciothes d er Clothes washer <br /> Ran e hood Water healer <br /> Exhaust fan Sink service/barlmo /etc. <br /> Heat um Backllow reventer <br /> Unrt heaier Urinal <br /> Boiler Drinkin Foun�ain <br /> Relri era6on Floor drain <br /> Woodstove Grease tra <br /> Ductin Roof drams <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM 14 Other: <br /> Number o(Head. Olhec <br /> I hereDy ce•'idy Ihal I nave rea0 ana eRaminee Ihis apo�:'�tion and know Ine s�me to�e We a�tl mRecl.All provisions of laws antl or0inances govem:ng Inis tyDe o'wod w�9 ee comp <br /> wd�wfielher speci6ed herein or nol.The granung ol a permil tloes�ol V�esume to gire aulhortty to��olate or cancel��e O�ovisian o�any oiher sla�e cr Iocn�law repulating conslNclion <br /> Tnai I am aui nze me owner of this pwpetty�a pertorm Ihe work�or whlch appll�a6on is made antl I comply w��h Ihe Slale ConVactors Law 1B27 RCW antl 796ZOOA WAC. <br /> 8/13/15 <br /> OwnerlAuthorize gent Signature Datc (Revised 9/2014J <br />