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*PERMIT APPLICATI J <br /> BUIL®INGIMECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOL (TION <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: PROPERTY TAX# PERMIT# O r <br /> l <br /> LEGAL for new construction: Short P t/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address 1431 r <br /> 6ILtj City/State/Zip ­gL T� <br /> APPLICANT:_Owner _Owner's AgentContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR fit State Lic.# City Bus. Lic.# �3 <br /> Address L}g �VG�✓ uJQ Phone/Email <br /> CONTACT FOR PERMITe J/7afina <br /> `_ <br /> Phone/E-mail Z- 1 - " I2 7 (Q Act)vil <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building __ Gas_ Electric_ Other <br /> Building type: ,L Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition K Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(addition I space p vided on the back): _/ tetj tL f/IC, QS)a4 <br /> A^dre-re©reg <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _,New-LAddn ,_,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 /> I Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby ce 'fy that I have read a d 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 w4specifiederei r t.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 ahe of roperty to performthe work for which a licati n is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> I�Ownege Signature D to <br /> Revised 4/2015) <br />