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0 0 <br /> PERMIT APPLICATION <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 /> SIT ADDRESS: PROPERTY TAX# PERMIT# <br /> / �� rA <br /> r� y�� j <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER A�fG P orYe/E mail (y <br /> Add(ess�/ /V 7 n �-; City/State/Zip <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 L- State Lic. #t ity Bus. Lic.# ? <br /> Address `js `7 Phon27Er- iI / S <br /> TENANT B SINESS ME CONTACT FOR PERMIT <br /> i�+ /tee Phone/E-mail il k ;k <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK "1111tb� <br /> Existing Use of Building �✓r ) y HEAT SOURCE: <br /> Proposed Use of Buildingl�i/!l�lilr�/1y �('Til!!sj l✓/r{�/ Gas Electric Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family -Commercial <br /> Type ofproject: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Gp u2`�r�1�rrGif7( 5 G <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 airs stems 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 /> Refri eration Floor drain <br /> Woodstove Grease trap <br /> 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 comps <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 a thonzed by the owner oSW§property to perform the work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> caner/Authorized Agent Signature D to (Revised 4/2015) I <br />