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*PERMIT APPLICATA9 <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 to PERMIT# <br /> -03 <br /> 44 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER y Phone/E-mail <br /> Address 2 / iL��.tl City/State/Zip 12 9lG Q <br /> APPLICANT: Owner _Owner's Agent 2CContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR G- State Lic.# ` ity Bus. Lic.# 6✓ ,23 <br /> Address 'L� f Z Phone/Email / <br /> TENANT BUSINESS NAIMt LI/ CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I F4 WL <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 /> i h,s{-�,ll ������-a- {-�2�c'..m� Gv� (,�•f'� S t�SZ v T �G�.�.�. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Adds _Alteration_Repair Type of Project: _New_,Adds _,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 Floor drain <br /> Woodstove Grease trap <br /> 6 I Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads I 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 wr 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 m a horized by the owner of t . roperty to perform the work for which application's made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> VIA- <br /> Owner/Auto a Ag na re D e <br /> Revised 4/2015) <br />