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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# PERMIT# <br /> 661I 3 G (/ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 1 e– AGh / Phone/E-mail <br /> Address 'L� �� « C City/State/Zip G <br /> APPLICANT:—Owner Owner's Agent _Contractor —Contractor's Agent enant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR State Lic.# City Bus. Lic.# <br /> Address I Phone/Email <br /> TENANT BUSINESS NAME CO TACT FO E MIT <br /> �ue �Si}rIC/7 <br /> Phone/E-mail L/21r" -?l1el <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building it HEAT SOURCE: <br /> Proposed Use of Building Gas�� Gas_ Electric_ Other <br /> Building type: =ingle Family —Duplex_Townhouse —Multi-Family _Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OFF WORK(additional space provided on the back): <br /> �999// ` ref �iz ��� �le4t �Gf� Gt�i <br /> O <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 z, I Toilet <br /> Forced airs stems I Bathtub <br /> Gas pipingLavatory 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 Drinkin 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 hereter/Authorized <br /> e 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 /> witherein 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 /> T 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. 2-1 <br /> Va . <br /> (Revised 9/2014) <br />