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1 • <br /> PERMIT APPLICATICill <br /> • <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 e PROPERTY TAX# PERMIT# <br /> c--r✓ 6t t,04`?'�'Z�l Oto c507-063 <br /> LEGAL for new construction:`/ Short Plat/subdivision Lot No. (attach copy of long legal description) / / <br /> OWNER T27 �'1 Phone/E-mail --2 -- i$✓z 31 t 6p/4,1 hia-€, tip <br /> Address& 4p? pz s�c-� City/State/Zip ria r (� 9L <4 <br /> • <br /> APPLICANT:?( Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR OI,()Vler State Lic.# City Bus. Lic.# • <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT�FOR pPERMIT _6 <br /> 9/4 Phone/E-mail �.oroel <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK W jt a(? <br /> Existing Use of Building 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 X Repair_T.I. Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the ck): Su��p f p„�tt*��,ts j_ad .e44-44 , <br /> ,,1sf.L dr,-., b�1'( u c z,a� <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 /> NC—air handling units Toilet <br /> Forced air systems 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(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 /> INumber of Heads Other: <br /> I hereby c-•'y at 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 complied <br /> with --ther s•ecifiied 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- I am autho'zed by the o i.- - is property to perform the work for which application is made(and I comply with the State Contractors La 8.27 RCW and 296.200A WAC. <br /> c zed Agent'' r• Date L f/Z- (Revised 4/2015) <br /> i <br />