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�RMIT APPLICATICj� <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#t IT# <br /> 4702 W Glen Haven Drive, Everett �� ��� <br /> LEGAL for new construction: Short Plat/subdivision __ ___.___Lot No. (attach copy of long legal description) <br /> OWNER Lee Oscar Phone/E mail �1/A <br /> Address site address c;ity/Stale/Zip <br /> APPLICANT:_Owner _Owner's Agent _�Contractor __Contractor's Agent _Tenant�rnus�prov�a�a ie«er or cor,se�,�rrom u,e oWnc��o do Worh�n me space� <br /> Pu et Sound Gas Works PUGETSG851 N6 eceip <br /> CONTRACTOR 9 State Lic. # City Bus. Lic. # <br /> Address 30326 36th ave nw stanwood, wa 98292 Phone/Emaii 360-629-6082 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Aimee Markley <br /> Phone/E-mail same as contractor info <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � � � <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Eiectric other <br /> Building type: X Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T e of ro ect: New XAddition 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 /> i 1����,�1 C�G�� �I� � �'�l'�I� +i��fi� I�' c� �k�;�'. <br /> � � �t; <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 handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in i Lavator wash basin <br /> j Water heater � Shower <br /> ; Gas fire lace Kitchen sink&dis osal <br /> ; Gas ran e ; Dishwasher <br /> i Clothes dr er j Clothes washer <br /> ! Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um i Backflow reventer <br /> � Unit heater � Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> i Woodstove Grease tra <br /> Ductin 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 Ihe 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 ihe owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW�296 200A WAC <br /> __ � ��� �'n�`v� <br /> OwncrlAuthorized Agent Si na ure Date �� U� (Revised 9/2014) <br />