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4477 PERMIT APPLICATION <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 i(E)everetteps@everettwa.gov I www.everettwa,govipermits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESSI 50b W CO . 11tk s:: 2d -AIS PROPERTY TAX#:00 E!4 cr--\CoatxY3 a e <br /> LEGAL fur new constracton, Snort playstrorr,vtswo_ __.„ ,,__,. _____ Lo n No. (attach copy Of long legal descopPon) k <br /> CONTACT INFORMATION <br /> OWNER NAME: 1.2a 4 Doo y TENANT NAME(If Commercial): ____ <br /> OWNER MAILING ADDRESS:, sir:I:ET <br /> CiTy STATE ZIP <br /> OWNER PHONE:6Q OO « 4.'10 . 06—4/3 OWNER EMAIL: <br /> CONTRACTOR NAME: Brennan Heating <br /> CONTRACTOR ADDRESS: $iiii-c: 4601 S 134th P1 <br /> L'ItY Seattle STATE WO zif, 98168 <br /> CONTRACTOR PHONE: 206-248-7900 CONTRACTOR EMAIL: Jaimie@brennanheating.com <br /> CONTRACTOR LICENSE#(RFQUIRFD): BRENNHA971R9 FcTr y OF EVERETT BUSINESS LICENSE U(REQUIRED): 028230 <br /> PRIMARY CONTACT: 0 OWNER pt CONTRACTOR 0 OTHER(Please Specify) , .. <br /> CONTACT NAME: CONTACT PHONE: 206-248-7900 <br /> Jaimie How CONTACT EMAIL: JaimieAbrennanheating.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of BuildingP V___ Contract Price of Work:$ I g LP173 _ — <br /> Proposed Use of Building Heat Source: OGas Eitiectric ClOther <br /> Bading Type: OSFR.Detached ErSFR-Attached ODuelex 0Multi-Family-#of Units, 0Commercial Olndustrial <br /> Type of Project E3New OAdditton ORernodei °Repair art. OSIn EISvrinkter ODemoldion OChan e of Use <br /> DESCRIPTION OF WORK,:12 4:0.4 c jc_ <br /> ASSOCIATED BUILDING PERMIT#(if applicable). <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 'Type of Project. New Addn Alteration Repair Type of Project: _New Addn Alteration Repair <br /> ft of fi of #of 1 I <br /> Fixtures <br /> List of Fixtures Fixtures List of Fixtures Fixtures List of Fixtures Fixturesof List of Fixtures <br /> NC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Root Drains <br /> Clothes Dryer 1-lookups Other: Clothes Washer , Medical Gas <br /> Range Hood 1. Water Heater Other: <br /> Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> , . <br /> SPRINKLER t SUPPRESSION SYSTEM <br /> Chemicat or Water a No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application arid confirm the information contained herein is true and correct Work done pursuant to this pent?",must cornety with <br /> current leo slate arof/mat law rhegfaetinp of a mime Only authorizes approved work and no devettionz therefrom,Deviations must fire be authorized in writing from roe <br /> Building Office)/beim being eirmionied Under any circumstance I are the owner,orient authorized by the ownef of INS Propotty to perform tho a ire tor which apphcofron tS,moth), <br /> ani curnp+3,with lho Moto Contractors t aw 1.5 27 NCW and 296 200A WAC <br /> City of Everett Official Use Only <br /> q PER <br /> a <br /> 0 rtAuthorized Agent Signature <br /> ii <br /> 5/0€31 i <br /> DateI , <br /> (Revised 9123/2016) <br />