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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 /> SITE ADDRESS: PROPERTY TAX# ERMI ^ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER C�y� j,t j" Phone/E-mail <br /> Address ��i pV F� <—, City/State/Zip Q1� Q <br /> APPLICANT:_Owner Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the ovmer to do work in the space) <br /> CONTRACTOR State Lic.# Clujett tCity Bus. Lic.# Orl(pr <br /> Address ;3L4 Uq T-,V o N_&t" )tL^Q.. Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> D amA, <br /> Phone/E-mail VUULQ cvsv <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK r,-!f <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building L Gas Electric Other__ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Sin_Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Clk- <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 airs stems 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 comp <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 1 am authori a 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 /> I I a-I <br /> Owner/Authorized Agent Signature Date ((�2vised 9/2014) <br /> c " <br />