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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# r, <br /> 4625 Seahurst Ave Everett WA 98203 ` I'� _� �I��� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Donette Rotta and Kusum Batey Phone/E-mail(206) 432-2914 / drkboom21 @yahoo.com <br /> Address 4625 Seahurst Ave City/State/Zip Everett WA 98203 <br /> APPLICANT: Owner Owner's Agent V—Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Smart Energy Today iState Lic.# SMARTET870BS City Bus. Lic.# <br /> Address 1001 Cooper Pt Rd SW Ste 140-290 Olympia, WA Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Kieran Yon <br /> Phone/E-mail (360)339-6660/kieran.y@smartenergytoday.net <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3.500 <br /> Existing Use of Building Home HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type:V Single Fa Hy _Duplex_Townhouse Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Residential Rooftop PV Solar System Installation <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 #)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 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 /> ,Owner/Authorized Agerif Si nature D to (Revised 9/2014) <br />