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WERMIT APPLICATICO nn <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITIOoN <br /> CITY OF EVERETT PERMIT SERVICES i ;. <br /> I� <br /> 3200 Cedar St., Everett, VVA 98201 425-257-8810 FAX 425-257-8857 www everettvv�il�rg v <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# L PERMIT#�� 7 <br /> a? /S /TT V 1 o v <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 22�2 � Phone/E-mail <br /> Address //4 - 02 6 T- City/State/Zip D u V/fLL f o l <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 �.LlG/may �,, L&I Lic. # f-e- 77 62S COE Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Jl4 t4 fty G'a.v.v i£ Fac�- �S.i ie 73 33a 3 x<T <br /> Phone/E-mail e6AsV .4-a <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �/� �ay•QU <br /> Existing Use of Building 00ef 7;iqiL HEAT SOURCE: <br /> Proposed Use of Building A?ZE i�!L Gas Electric_ Other_ <br /> Building type: _Single Family Duplex_Townhouse _Multi-Family X Commercial <br /> Type of project: _New _Addition Remodel _Repair_T.I. Sign_Sprinkler Demo Iition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): Za—IF-D C - -7 - eSlG N '!!74 T A <br /> /N5T/-}Lt. itJ E-tt} LtJ�LL .S !G N ��Ort �r�tl�Ltl14S! •• <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 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 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 Signatu Date (Revised 6/2012) <br />