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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: J PROPERTY TAX# PERMIT# <br /> `" f r /'c'P l r r;, I-✓A. �/ �,'1 ��c�`� - Oo1 <br /> LEGAL for new construction: Short Plat/sub4iivision Lot No. (attach copy of long legal description) <br /> OWNER f" /Iiy r a V C.7° tiov S'a- Phone/E-mail <br /> Address 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 a,/°/$Pw,, ,i0/4 4,j 4 �' z f- L&I Lic.# n//sP (/,0� COE Bus. Lic.# <br /> Address POPO60 X /1 Jyll h W 6 G /W U• 5'7/t/6 Phone/Email i-ja S (7, C 9 C/t <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> :Gt In, LC fi Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK. `IjLXC 1:;1 <br /> i Cs <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): <br /> Y‘' t--(\e4 (Nei:-.) ne.sr-c.,÷ d C-tc-s cr Cook \ n� <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 j Shower <br /> Gas fireplace 'i Kitchen sink&disposal <br /> Gas range j Dishwasher <br /> Clothes dryer j Clothes washer <br /> Range hood f;, Water heater <br /> Exhaust fan ,? Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater ( Urinal <br /> Boiler I Drinking Fountain <br /> Refrigeration _ I Floor drain <br /> Woodstove ,' Grease trap <br /> Ducting j Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads I 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 /> (/` <br /> Owner/Authorized Agent Signature Date (Revised 6/2012) <br />