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OPERMIT APPLICATI <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: `2r^�' 1 CLUB O PRO_PERTY1 AX dO PERMIT <br /> RMIT# <br /> LEGAL for new construction: Short Plattsubdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER �� Phone/E-mail ] �cJ q5- <br /> Address Ll l Vl✓1 City/State/Zip <br /> S <br /> APPLICANT: Owner _Owner's Agent —Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR o State Lic.# City Bus. Lic.# <br /> Address �jQ.r►v� Cv r ��� Phone/Email TENANT BU51NESS ME l�1 Cv"`t�s •1��'. <br /> CONTACT FOR PERMIT <br /> �4esA ���,� "�-4- � e,�'c ,� �4� - 00-SV SY <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building ye� -co SLOP HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other-- <br /> Building <br /> ther_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 /> OJ& 5 � y 5 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _ _ <br /> 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 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(inside bldg) <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 complied <br /> with wheth r specified herein or not ming 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 a e by the ow of this perty 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 /> eIfSi <br /> h rize en igrrat ate (Revised 4/2015) <br />