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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: IPROPERTYTAX# PE IT# <br /> 2Ay <br /> LEGAL for new construction: Short Plattsubdivision Lot No. (attach copy of long legal description) <br /> OWNER LPhone/E-Phone/E-mailZ-OG-5,�6 - QAddress r y/State/Zip ZQ l <br /> APPLICANT:—Owner _Owner's Agent _Contractor —Contractors Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR State Lie.# City Bus. Lic.# 3p <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Lj WA. X <br /> P15TI"JAIC-t Al 0.27-t=CM <br /> Phone/E-mail -0 i wr-A. ' W1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building D HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family X Commercial <br /> Type ofproject: New Addition Remodel _Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): /`���- `� �C`C IMF�eojE�f"Effr <br /> F09 FLuewAT�F-P. PISTILI I ,16 TYAT I Vu-vim sF of ��AP D REsrt <br /> lC60ACS Akb TS8 SF SIT CCPPC�Z.. <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 airs stems 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 /> Refricieration 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 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 /> /Z <br /> caner/Authorized Agent Signature ate (Revised 9/2014) �� <br />