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PE MIT APPLICATION <br />BUILDING/MECHANICA LUMBING/SIGN/SPRINKL�/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 />�SITEADDRESS: ��� `�D � � �...� �� <br />LEGAL for new construction: Short PlaUsubdivisio <br />OWNER r r � �►- ���-� �y �� � <br />Address �� � l,�' �F� � (�� � � <br />APPLICANT: _ Owner _ Oavner's Agent <br />� 1 <br />CONTRACTOR Q, I {�Y <br />Address l r0 <br />TENANT BUSINESS NAME <br />Y � <br />`�'f:J <br />� <br />Lot No. (attach copy of long legal description) <br />'it ` <br />Phone/E-mail �`�l1� �� �� , 1 � �� � � /� <br />, y� �—p�� � <br />City/State2ip �"'�i'���� : _�%�i f"1 M �..' � � � <br />Contractor _ Contractor's Agent T0(13f1t (must provide a telter of cnnsent from the owner lo do work in Ihe spacej <br />State Lic. #� �� �'i J�T City Bus. Lic. # �`� V <br />���' w � q$�' Phone/Email �'� 25 ! `,Ql�� <br />CONTACT FOR PERMIT <br />y1'r��.b�.� �25 �5�Q t����v <br />Pf�c�ne/E-mail/�p i�A IP.I-. l;{N�YLYC1.�1 �Q' �� <br />IBUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK � .•� � �� <br />Existing Use of Building <br />Proposed Use of Building Gas <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 rinkier [ <br />DESCRIPTION OF WORK (additional space provided on the back): <br />HEAT SOURCE: <br />Chan <br />r� <br />Other <br />- �� �� ���5 ��� i�u,�� <br />�� �� <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 Num6er #) of fixtures <br />A/C — air handlin units � Toilet <br />Forced air s stems I Bathtub <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />Boiler <br />Refriaeration <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />h basi <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/barlmop/E <br />Backflow preventer <br />Urinal <br />Drinkinq Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medicai Gas <br />Other: <br />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 he comp; <br />with whether specified herein or not. The granting ot a permit does not presume to giva authority to violate or cancel the provision ot any other state or local law regulating construction <br />That 1 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 16.27 RCW and 296200A WAC. <br />` .J <br />� as (Revised 9/2014) <br />Owner uthorized Agent gnature <br />