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• s <br /> PERMIT APPLICATION <br /> BUILD1 NG/MEC HANICAL/PLUMBING/SIGN/SPRIN KLER/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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS- � PROPERTY TAX# RMIT# <br /> < S <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER E-mail <br /> Address O` — City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent _Contractor 2�ftntractor'sAgent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR C 1 ( /v IS —L-1 L&I Lic.# CvC-<=Rl" - 9 LJ<NE Bus.Lic.# <br /> Address P,D, 3 17 Phone/Email( ) -- 74 4 <br /> TENANT BUSINESS NAME _ CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WOR <br /> Existing Use of Building �ti IWI _ �d�� _ 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. i n_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> t <br /> .�.-rtgt-� New ��c�►-� ���- r (, � � °�� <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 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 /> 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 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 slate or local law regulating construction <br /> That I am authorized by the owner of this property to p the work for which application is made and I comply with the Stale Contractors Law 18.27 RCW and 296.200A WAC. <br /> �olc 0611/62- <br /> Owner uthorized gent Signature ate (Revised 6/2012) <br />