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tERMIT APPLICATIA. <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRIN KLER/DEMOL,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: PROPERTY TAX# PE71T;# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail /,C? -C 121-1 1)4'1 <br /> Address 6, 7 City/State/Zip )e-A, L IA a z")6j <br /> APPLICANT:X Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work in the space) <br /> CONTRACTOR y State Lic.# City Bus. Lic.# <br /> Address es /�. 2 [� / Phone/Email:�,er(, <br /> CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building �'T=iT t���n' / HEAT SOURCE: <br /> Proposed Use of Build ing­S/)1 1E— � Gas_ Electric_ Other_ <br /> Building type: ,_Single Family _Duplex_Townhouse _Multi-Family X/ Commercial <br /> Type of project: New V Addition _Remodel _Repair_T.1._Sign_Sprinkler Demolition _Change of Use <br /> DESCRIPTION OF WOAK(additional space provided on the back): ) /, <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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> I 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 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 /> petty to perform t work for which a plication i made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> That I am authorized by the ownerof this pr <br /> Owner/Authorized Agent Signature ate (Revised 4/2015) <br />