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• • <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:z- /���zi.--A/ PROPERTY UC'4{-5AYZOO/OCOOO PERMIT <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERz-77- y, /// /-/y��J'2/G//y Phone/E-mail c/25:—/757?92 Z L o r�/ <br /> 6 <br /> Address d/( 7 5 3'7 City/State/Zip l�E ��27 iV7 tf2O <br /> APPLICANT: /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 • State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS <br /> NAME /� CONTACT FOR PERMITQOA/ Q�/ / '/ // <br /> � 1A /// " Phone/E-mail/ � 7L//� 37r /ec/tl/I/eE Y�/7, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK y7.5--,• CID <br /> Existing Use of Building sr� HEAT/ SOURCE: <br /> / <br /> Proposed Use of Building Gas /Electric Other <br /> Building type: Single Family _Duplex Townhouse ✓Multi-Family 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 /> (1,/ 'J� MT 4M2 , 6T4 T-e—rc <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration Repair Type of Project: _New Addn _Alteration VRepair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub • <br /> Gas piping Lavato wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&dis•osal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes <br /> Range hood Water heater <br /> Exhaust fan •- •• <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinkins Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads Other: <br /> I hereby certify that 1 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 comps <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 a th 'ed by the 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 /> OwnerlA�rf�fAgent Signature Date (Revised 9/2014) <br />