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• TAPPLICATi <br /> BUILDING/MECHANICAL/PLUMBI NG/SIGN/SPRINKLERMEMOL,ITION <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: p PROPERTYTAX# y P !RMITO <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) �1�,.�,, . <br /> OWNER 6Q Phone/E-mail G �' •e 111" <br /> Address �� � � City/state/Zip S Cv►4 ti�� <br /> APPLICANT:'--bwner _Owner's Agent ontractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR tp C —s-0j C-;T-10 State Lic.# Cc, Lity Bus. Lic.# <br /> AddressPhone/Email <br /> TENANT BUSINFSS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gasa Electric_ Other <br /> Building type: •_Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.1._Sign_Sprinkler Demolition _Change of Use <br /> DESCRIPTION OF WORK(additional <br /> " C1v CiBrtMUNspacervided on the back) <br /> L �a : <br /> � ` �N <br /> 425-0 120a M <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Alteration Repair Type of Project: _New_Addn __Alteration rRepair <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 J 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 s ci ted 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 ori d by the owner this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.20DA WAC. <br /> Own / uthorized Agent Si nature Date (Revised 4/2015) <br /> �`v <br />