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0 PERMIT APPLICATIM& <br />BUILDING/Ii ECHANICAL/PLUM61NG/SIT/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evereftwa.org <br />SITE ADDRESS: <br />PROPERTY TAX# <br />PERMIT# 02-0 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of Ibng legal description) <br />OWNER �!C <br />Phone/E-mail <br />Address <br />ity/5tate2ip <br />APPLICANT: 4bwner _ 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 <br />State , # City Bus. Lic. # <br />Address <br />Phone/Email <br />TENANT BUSINESS NAME: <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building 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 />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 />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />I <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other: <br />Other: <br />Number of Heads <br />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 />That I u fiae erty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAG. <br />/ (Revised 4/2095) <br />Owner/Authorized Agent Signature Date; <br />