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�'ERI�IIT 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 /> SITE ADDRESS:� PROPERTY TAX it PER IT� '� ' <br /> � � . <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. {attach copy of long legal description) <br /> OWNER M� � Phone/E-mail <br /> Address� J City/State/Zip �/ � � Z I <br /> APPLICANT:_Owner _Owner's Agent �Contractor _Contractor�S Ag2flt _T0f18f1t(must provide a lettar of consent from the owner to do work in the space) <br /> CONTRACTOR � E State Lic.#�-t�,, City Bus. Lic.# ��� ��' <br /> Address � �� � � Phone/Email �' � '�� .���" � <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ����P� <br /> �� `� Phone/E-mail 3�p�j • 5•� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK SOO <br /> Existing Use of Building G HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family �Commercial <br /> T e of ro'ect: New Addition Remodel �Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> �l PC.-���pC—, S�s—r� � c��- 30� <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 handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin 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 comp <br /> with whether specifed 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 uthorize by the owner of this property to perform the work for which appli ation is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 11�1 1�� <br /> O er t orized Agent Signature ate (Revised 9/2014) <br />