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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 — FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS 215 Mukllteo Blvd PARCEL TAX I.D.# PERMIT# <br /> 29043600101400 _ 0-13 <br /> LEGAL LOT NO. BLOCK TRACT OR SUBDIVISION# <br /> DESC. <br /> OWNER ADDRESS CITY/ZIP PHONE <br /> Our Saviours Lutheran Church 215 Mukilteo Blvd Everett, 98213 (425) 252-0413 <br /> TENANT NAME CONTACT FOR PERMIT PHONE (360) 661-0032 <br /> Our Saviours Lutheran Church Mike Crider E-MAIL mikeC@rhmech.com <br /> CONTRACTOR ADDRESS CITY/ZIP PHONE <br /> R&H Mechanical 1711 Port Drive Burlington, 98233 (360) 757-6909 <br /> CONTR. LICENSE# <br /> RHMECI*951 LC <br /> USE OF BUILDING HEAT SOURCE CONTRACT PRICE OF WORK <br /> Church Electric X Gas Other $80,032.00 <br /> WORK DESCRIPTION <br /> Install 2 10 ton RTU's, 1 furnace, 1 split system heat pump, a duct heater with fan and all associated <br /> ductwork, gas piping, refrigerant piping, controls and control wiring and trim for a complete installation <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM NO. TYPE OF FIXTURE OR ITEM <br /> Toilet 2 A/C—air handling units <br /> Bathtub Forced air systems <br /> Lavatory(wash basin) — Gas piping <br /> Shower Water heater <br /> Kitchen sink&disposal Gas fireplace <br /> Dishwasher Gas range <br /> Clothes washer Clothes dryer <br /> Water heater Range hood <br /> Sink(service/bar/mop/etc.) Exhaust fan <br /> Backflow preventer Heat pump <br /> Urinal Unit heater <br /> Drinking Fountain Boiler <br /> Floor drain Refrigeration <br /> Grease trap Woodstove <br /> Roof drains --f Other Duct Heater <br /> Other <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105D <br /> hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume <br /> to give authority to violate or cancel the provision of any other state or local law regulating construction or the performance of <br /> construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the <br /> State Contractors Law 18.27 RCW and 296.200 WAC. <br /> 4/28/16 <br /> Sig;�M' q'�,kl. 6'flContractor/Authorized Agent Date <br />