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PERMIT APPLICATION <br /> BUIL.DING/MECHANICA /PLUMBINGISIGN/SPRINKLERMEM0alMI <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.arg <br /> SITE ADDRESS PROPERTYTAX# TWIRMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No.! (attach copy of long legal description) <br /> OWNER � p-oll'tS Phone/E-mail �t7>-- <br /> Address 2"r/Ztrw- City/state/Zip <br /> APPLICANT:—Owner _Owner's Agent Contractor —Contractor's Agent _Ten a nt(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR ��� - ��Z� &mon State Lic.# City Sus. Lic.# &0-11157 <br /> Address 2-V20 AC-trLC ill C 0:r2tr—t ur•A ZD( Phone/Email 4 <br /> TE INESS NAME CONTACT F _R PERMIT <br /> Cd f <br /> C-k-z 7/2)MS Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �2 zS <br /> Existing Use of Building M) �EI�F��t HEAT SOURCE: <br /> Proposed Use of Buildings � w��r;'C Gas K Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: _New —Addition _Remodel Repair—T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ut;w <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteratio�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 I 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(inside bldg) <br /> Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting j Roof drains <br /> Other Medical Gas <br /> SPRINKLER 15UPPRESSIOM 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 a uiF grized 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 296.2ooA WAC. <br /> Date (Revised 4/2015) <br /> Owner/Authorized`ge Signature <br /> LL <br />