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• <br /> PERMIT 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# PERM', T# <br /> tr LZ_ u <br /> LEGAL fo new construction: Short Plattsubdivision Lot No. (attach copy of long legal description) <br /> OWNER �" , Phone/E-mail_T at <br /> Address C of—,L_ City/State/Zip y <br /> APPLICANT:—Owner _Owner's Agent —0cOntractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTORL&I Lic.#S COE Bus. Lic.# <br /> Address f�` ! ' ' hone/Email 2- <br /> -;--2-,7 C r_,c <br /> TENANT BUSINESS NAMff CONTACT FOR PERMIT <br /> 1>(.i'jc�� _ �L� . f -4 C-.: L Phone/E-mail <br /> BUILDING PERMIT A LIGATION CONTRACT PRICE OF WORk 7COCl <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <br /> Building type: _Single Family _Duplex_Townhouse —Multi-Family A Commercial <br /> Type of project: New Addition Remodel _Repair_T.1._%efSign_Sprinkler_Demolition _Change of Use <br /> DESCRIPTION OF WORK(additional <br /> ?space provided on the back): <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 state or local law regulating construction <br /> That I 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 18.27 RCW and 296.200A WAC. <br /> /-lZ -lf <br /> Own uthorize nt Signature Date (Revised 6.12012) <br />