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WE R, MIT A PPFUCATKAD <br />PSRJI D IiWhIMLEECH ANIC s LIP LUMBIiVGMGMISPRINK UE >>6DEMOUTi ION <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: <br />- <br />PROPERTY IA)(## <br />�F�Ri Il #„ F, ® 0 <br />c <br />l: <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER — <br />Phone/E-mail <br />Address ('�y `�ytiit7(�11i� <br />City/State/Zip <br />APPLICANT: _ Owner owner'sAgent Contractor —Contractor's Agent _Tenant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR A 6 State Lic. # ` -Z-OT` City Bus. Lic. # may' <br />� <br />Address l � } 1 46'C" <br />Phone/Email <br />TENANT BUSINESS NAME <br />— T <br />CONTACT FOR PERMIT <br />I�Ltj 'SAL,-3 <br />Phone/E-mail-- <br />BURLDING PERMIT APPLICA i IOM <br />CONTRACT PRICE OF WORK �y� . <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building <br />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 />KVNtc—e'Titb <br />MECHANICAL PERMIT APPLICATION PLUMMUMG PERMIT AE'PUCAT1 ION, — <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 />1 <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />i Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />( <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM --- <br />� <br />Other: <br />Number of Heads <br />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 granti 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 p y 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 />XA [ <br />Owner/Auth dzed Agent Signature Date (Revised 312013) <br />