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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES CI ' -) --►C <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS:a;;4t1, '1 - ce ,/1_ n PROPERTY TAX# I P IA ;V��l I 0 I <br /> LEGAL for new construction: Short Plat/subdivision I(�(/ Lot No. (attach copy of long legal description) <br /> OWNER1 t.(, P Phone/E-mail <br /> II —Address lot- '. 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 C�� 1 State Lic.# City Bus. Lic.# <br /> Address cA cd 6,A..9-€,.. Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail yy�� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK,( 2-'100. ----- <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 Repair_T.I. Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back):,...e2.0..A..,ek:t <br /> WIr 1j8i,()5 <br /> €° loor <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 I 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 /> 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 comp) <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 authorized by the owner•f 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 /> (NA100__ C35/7r <br /> ner/Auzed Agent Signatur / �j Date (Revised 9/2014) <br /> • <br /> ell c74h " G <br />