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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# PERMIT# <br /> � �i G G� <br /> LEGAL for new construction: Short PlaUsubdivision See t]le attgClled �2]ariS Lot No. (attach copy of long legal description) <br /> OWNER PEO IeS �ari�c Phone/E-mail <br /> Address 418 Grove St City/State/Zip I, nden, WA 98264 <br /> APPLICANT:_Owner _Owner's Agent �Contractor _Contractor's Agent _Tenant(m�s�pro��de a iene�ot consenc trom ene owner ro do work�n me space� <br /> CONTRACTOR ohansen Mechanical Inc. State Lic. # QHANMI173PK City Bus. Lic. # tq Z��,, <br /> Address 20109 144th Ave NE, Woodinville, WA 98072 Phone/Emai� 425-481-2266 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Peo les Bank Ivy LeVangie: 425-481-2266 /ivyl@johansenmech.com <br /> p Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK $14I1,21E� <br /> Existing Use of Building Rank HEAT SOURCE: <br /> Proposed Use of Building S3ri1e Gas Electric� Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family �Commercial <br /> T e of ro ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> HVAC upgrade per plan, equipment listed below. <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(#J of fixtures <br /> 12 A/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavator wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes dr er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> 9'J Other (TR1�.� Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I here6y 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 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 a zed by the ow this propeRy to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br /> �il �-- - � � � � � ��, � _ d�� �� <br /> Owner/A onzed YSignature ate (Revised 9/2014) <br />