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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: PROPERTY TAX# PbI(3 <br /> MI # <br /> • 7// G/s7ft Sr 6ui 71L/W [` <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER f /5S`//(IL,{- r° /Nit-J1 Phone/E-mail <br /> Address 7// t--/1 5 r (�� //&f�'/�// City/State/Zip <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 O(,()/(/6 R State Lic.# City Bus. Lic.# <br /> Address 71 r �� � ' z f3 ? � 2# Phone/Email 21c '4 7 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 7Noo. D0 <br /> Existing Use of Building v/ HEAT SOURCE: <br /> Proposed Use of Building 171L4£i Gas Electric Other <br /> Building type:.ngle Family Duplex_Townhouse —Multi-Family Commercial <br /> Type of project: —New - »adition _Remodel _Repair T.I._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> • <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 /> 1 NC—air handling units j Toilet <br /> Forced air systems j Bathtub • <br /> Gas piping j Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace Kitchen sink&disp•-al <br /> Gas range ( Dishwasher <br /> Clothes dry; j Clothes was <br /> Range hi.•d Water he- -r <br /> Exh- t fan • Sink rvice/bar/mop/etc.) <br /> H=-t pump B-• flow preventer <br /> nit heater 4rinal <br /> • Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> PRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads j Other: <br /> I 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 />