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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBINGISIGN/S PRINK LE RIDE MO LIT ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE A DRES PROPER TAX ; P RMIT# <br /> 10 7. t q c; <br /> LEGAL for new construction: Short Plat/subdivision I&J AO • Lot No. (attach copy of long legal description) <br /> OWNER . bLTPhone/E-mail <br /> Addressgn F�JZAAI City/State/Zip <br /> APPLICANT:__Owner __Owner's Agent X'Contracto Co tractor'sAgent __Tenant(must provide a letter of consent from the owner to do work in the space) <br /> 11603-27 7"719t: <br /> CONTRACTOR L& I Lie.# S COE Bus. Lie.# <br /> Address , 3 Phone/Email <br /> TENANT BUSINES NAME CONTACT FOR PERMIT <br /> }}& P<�L17CfC iovw� �-- Com) 696—It 6 z_ <br /> Phone/E-mail C�jy�/� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT E: <br /> Proposed Use of Building e r/YL a. as_ Electric_ Other__ <br /> Building type: —Single Family _Duplex—Townhouse _Multi Family mmeraal <br /> Type of project: New _Addition —Remodel _Repair_T.I.Xsign_—Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1, <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(0)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 <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> OtherMedical 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 /> That I am authorized by the owner of this property to pert rm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> wnerlAut orizedAgen ignature Efate J (Revised 6/2092) <br />