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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: / PROPEFkTY TAX# PERMIT# <br /> C) V <br /> LEGAL for new construction: Short Plat/subdivis ion Lot No. (attach copy of Tong legal description) <br /> OWNER Phone/E-mail -z <br /> Address'` k— G'Z C' City/State/Zip G' 1 <br /> APPLICANT:_Owner _Owner's Agent I Contractor Contractor's Agent Tenant(must provide a letter of consent from the ownerto do work in the space) <br /> CONTRACTOR 7k State Lic.# �j C City Bus. Lic.# <br /> Address ��4C1 e Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 2100yQ <br /> Existing Use of Building(efww1 p. I a-C HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other__ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family r` Commercial <br /> Type of project: New Addition Remodel Repair T.I. Sin Sprinkler_Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> f , <br /> '�\t/✓jam. � v�, \�At�c� \y1�lAC �Q <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 /> 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 compl. <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 Signature Date (Revised 9/2014) `� <br />