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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 /> LEGAL for hew construction: Short Flat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER (9 l r1 5, F®1C Phone/E-mail <br /> Address C z�' — "z (� cs' 7 City/State/Zip E47 e 4e 9 9&63 <br /> APPLICANT: h---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 ", \„/\( e State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building J�'� HEAT SOURCE: <br /> Proposed Use of Buildin a t _,�c /► <br /> 1 �IMG.chec Gas_ Electric Other_ <br /> Building type: tingle Family —Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project: —New ry Addition _Remodel _Repair_T.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 9152.to <br /> p � - --` . <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 /> A/C–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 <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> 1 Refrigeration j Floor drain • <br /> Woodstove Grease trap <br /> Ducting f Roof drains <br /> Other ' Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM I 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 complied <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 am authorized 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/Authorized Agent Sig atu Date <br /> (Revised 3/2013) <br />