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` 1 <br /> ,�.�f e 9 l r <br /> i b y „ t4..,.. <br /> t <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 /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> 2415 W Mukilteo Blvd 004170-002-012-00 e,l0(_01 (0 <br /> LEGAL for new construction: Short Plat/subdivision map of darl ington Lot No. 12 (attach copy of long legal description) <br /> OWNER Michael & Mindy Newton Phone/E-mail <br /> Address 2415 W. Mukilteo Blvd City/State/Zip Everett, WA 98203 <br /> APPLICANT: X Owner _Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR High Definition Const . State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CQNTACT OR PERMIT <br /> llen. be-l l llltitea„yyo64//S2G,,rvx t,uon-\ <br /> Phone/E-mail 0-72 2 -6_4'15- <br /> BUILDING <br /> 6_4/5BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building SFR HEAT SOURCE: <br /> Proposed Use of Building SFR Gas Electric Other <br /> Building type: X Single Family Duplex Townhouse Multi-Family _Commercial <br /> Type of project: _New X Addition Remodel Repair_T.I._Sign Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Addition of ADU <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New X Addn _Alteration_Repair Type of Project: _New X Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> / NC—air handling units I Toilet <br /> / Forced air systems Bathtub <br /> Gas piping I Lavatory(wash basin) <br /> / Water heater I Shower <br /> Gas fireplace / Kitchen sink&disposal <br /> Gas range r Dishwasher <br /> / Clothes dryer I Clothes washer <br /> / Range hood <br /> 2 Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump / Backflow preventer(inside bldg) . <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 /> Th-�=m uthorized by •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 /> '�>�:�t,. 1 (�i -M- - <br /> •caner/Authorize Agent S'`n•ture� Date (Revised 4/2015) <br />