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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 /> SITTDRESS: FPROPERTVTAXt _ :ERMIT# <br /> LEGAL for now construction: Shon Piat/suwlvlslon Lot No. (attach copy of iong legal description) <br /> OWNER \TVIIV— r�� Phone/E-rnail <br /> �-, (�TQC t e �k 4 1.,:� I ` , <br /> Addre55^ City/State/zip <br /> APPLICANT;_Owner Owner's Agant Contractor _Contrectar's A9 ant _Tenant(moat provide t1 IeHor of cnnsant lrom the ov orto do work In tho:pncn) <br /> CONTRACTOR State Llc. Ci Bus. Lic, # <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT,A,PPLICATI CONTRACT PRICE OF WORK C <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Elactric Other <br /> Building type; _Single Family _Duplex_TownhoUSe _Multi-Famlly Commercial <br /> Type of project: New Addition Remodel Repair 11. Sin sprinkler Dentrolition Chane of Use <br /> DESCRIPTION OF WORK(addltlonal space provldod on the back): <br /> MECHANICAL PERMIT APPLICATION PLU 11ING PERMIT APPLICATION <br /> Type of Project: _Now_Addn _Alteraklon_Repair Type of Project: _Now_Adtln Alteration Repair <br /> Show Number ft of fixtures Show Number of bxtureg <br /> E4A/C—air handlin2 units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavato Wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Rance hood water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um Backflow reventer inside bl'd <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> R2fricieration Floordrain <br /> Woodstove Grease trap <br /> Ductinr <br /> q Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other. <br /> Number of Heads Other <br /> I hnmby camrY that I hnvp read end examinee this application and know fho same to be true and correct,All proviciona of Invrs end ordinsnctn governing thin lypn of work will be comp) <br /> With whether npoclfled herein or not,The.gmnfing of a permit doer not presume to give Agthority to violate or cancel the provision of Any other state or lochl law regulating constructlbn <br /> That I dm authorized by thn owner of this property to perform the work for which application Is made.And I comply with thn.Mato Contractors Lnw 1A.27 RCW and 290.200A WAC. <br /> Owner/Authorizetl Agent�Slgnaturti Date (Ptsvised 4/1095) <br />