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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:6O 7/4/344.217 PROPERTY TAX# ; l1# <br /> LEGAL for new construction:/ Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> 67(7 <br /> OWNER7 7//6 1("7"&i e (/Phone/E-mail ��,j 2,? 9Z Z <br /> Address gQ% /3 97 / City/State/Zip / 77 jr� ff2�6 <br /> APPLICANT: t/ 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 6nr7 • State Lic.# City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ."-- <br /> Phone/E-mail/1-r7L5G, 6 J �� /e0/01/eZ /yAnleiS <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 9q-Cl 0 <br /> Existing Use of Building r HEAT SOURCE: <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 /> AT ,//4" <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration V'Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units I Toilet <br /> Forced air systems 1 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 /> (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 compl <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 /> Owner/ized Agent Signature Date (Revised 9/2014) <br />