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0 • <br /> PERMIT APPLICATION <br /> BUILDING/MEC HANICAL/PLUMBI NG/SIGN/S PRI NKLER/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: PROPER TAX# PERMIT# <br /> c t �dO�CU7Oc�3(' <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER cj,' 1 Phone/E-mail DL <br /> Address G '+J fih S S w �b City/State/Zip L d <br /> _ )C / <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 ` by State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �Q—Q� <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of BuildingS�I� Gas_ Electric ",` Other <br /> Building type: X 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 /> 1 <br /> LA <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 /> j A/C—air handling units Toilet <br /> Forced air systems j Bathtub <br /> Gas piping Lavatory(wash basin) <br /> i Water heater Shower <br /> Gas fireplace ! Kitchen sink&disposal <br /> j Gas range Dishwasher <br /> j Clothes dryer j Clothes washer <br /> Range hood j Water heater <br /> Exhaust fan toI Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> I Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> i Refrigeration j Floor drain <br /> Woodstove Grease trap <br /> Ducting j Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> 11 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 togive authority to violate or cancel the provision of any other state or local law regulating construction <br /> That Ia uthorizLr 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 /> Ow r/ uthorized Agent Signature Date (Revised 3/2013) <br />