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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 /> SITE ADDRESS: PROPERTY TAX# P RMIT# <br /> 1728 W. Marine View Dr. 29051800301300 <br /> LEGAL for new construction: Short Plat/subdivision SEC. 18 TWP.29 RGE. 05 Lot No. (attach copy of long legal description) <br /> OWNER Mike Balicki-Costal Real Estate Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner X Owner's Agent Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR TBDn <br /> State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Bay Psychiatric Jesse Wolfe-2812 Architecture <br /> Phone/E-mail (425)252-2153 jesse@2812architecture.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $50,000 <br /> Existing Use of Building Medical Office HEAT SOURCE: <br /> Proposed Use of Building Medical Office Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse Multi-Family X Commercial <br /> Type of project: New Addition Remodel Repair T.I. X Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Demo of existing walls,doors,and casework. Reorganization of space to include new walls,doors, and casework.As well as deferred <br /> submittal (Fire sprinkler, mechanical,fire alarm,electrical, plumbing) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: NewAddn _Alteration_Repair Type of Project: _NewAddn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat 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 comp <br /> with whether specified herein or not.The granting ofa 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 ac�thodzed by the owner f this propert erform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> ner/Authorized Agent Signature Dae (Revised 9/2014) <br />