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IERMIT APPLICATI09 <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/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: PROPERTY TAX# PERMIT# <br /> , � ►Y7GLt1 Li�CI � I a-7 <br /> LEGAL for new construction: Short Plat/subdivision �u Lot , (attach copy of long legal description) <br /> OWNER �� ear Phone/E-mail �j 3 � j`� �V Ikc 2PSQf <br /> Address k--4r u0-CAM <br /> Q5S City/State/Zip Fido–' +f– Wr v• c �ZQ <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 �5�y> (�(�u��l(�z State Lic. # City Bus. Lic.# Caw ;C <br /> Address Phone/Email 7 6) - —7Tfc/ 2— <br /> TENANT <br /> SI 1 NAME <br /> M/,/� ,/ /� /^�� (�y� CONTACT FOR PERMIT r <br /> `C'V{ 1i �-er IV1 t/" q(fbl?� 1r� hone/E-mail [ir I VZA-ZC��IC.1 <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: ,_Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition Remodel Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTIO! OF WORK(additional space provided on the back): <br /> C 6-CLkw(64,e Ia ( k' ( t t,le4`) <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 /> I 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 1- Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> _ Boiler I Drinking Fountain <br /> ! Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting Roof drains <br /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> I 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 /> That I am authorized by the owner 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 /> OwndrrAufhorfted Agent Signat re � (Revised 4/2015) <br />