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0 • <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 /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> i UI-OIC <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER Gr/L / ;, ) Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:—Owner _Owner's Agent _Contractor —Contractor's Agent �Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR State Lic.# City Bus. Lic. # <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PL--1F7> x/1'1'1 A�-%"L <br /> Phone/E-mail LS_ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building A i,J: 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_fI. Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional 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 /> I Forced air systems j Bathtub <br /> Gas piping j Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace j Kitchen sink&disposal <br /> j Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> i Exhaust fan Sink(service/bar/mop/etc.) <br /> j Heat pump i Backflow preventer <br /> j Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration j 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 /> Owner/Autfiorized Agent Signature t Date (Revised 312013) <br />