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,q,w 0 0 <br /> 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> 4027 4th St SE., Everett, WA 98201 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER City of Everett Phone/E-mail <br /> Address PO Box 12130 City/State/Zip Everett, WA 98201 <br /> APPLICANT: Owner Owner's Agent X Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR D.K. Systems, Inc. - DKSYS1*9821­1 IL&I Lic.# 030,428-00 COE Bus. Lic.#049744 <br /> Address PO Box 886, Burlington, WA 98233 Phone/Email 360-755-1555 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Darron Drake 360-770-0950 <br /> WPCF Admin Bldg - Boiler Replacement Phone/E-mail darron@dksystemsinc.com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK.$ 2.000.00 <br /> Existing Use of Building Water Pollution Control Facility HEAT SOURCE: <br /> Proposed Use of Building Water Pollution Control Facility Gas X Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse —Multi-Family –X Commercial <br /> Type of project: _New —Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Install (1) New "Like for Like" Customer supplied Boiler. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn X 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 air systems 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 complied <br /> with whether specified h rein 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 m authorize t e 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 /> 09/19/2016 Oq , ()G 0 <br /> Owner/Authorize Agent Signature Date (Revised 6/2012) <br />