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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 /> SITEA DRESS: PROPS TY TAX# P�k^MIT# <br /> �� I Com- 00 - g< - � sow /V11 0 - <br /> LEGAL fpr new constructlon:,ShortPlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNECR m'i Ck 0,-tl a- 1 PhonofF-mail <br /> Address City/statelzip <br /> AIPPhICANT. Owner _Owner's Agent kContractor _Con tractor's Agent Tenant(must provide o 19morr of conten'from the o—or to Oc vmrkk In 1ha/sp6ce) <br /> CONTRACTOR Slate Lic.# �"I City Bus. Laic. <br /> Address w a -�^ ` lt— g �$ Phone/Email `Dtp <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT a{ t mit- } <br /> PhonefE-mail'1l,W YYVI'LC� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK CC-) <br /> Existing Use of Building _ HEAT SCIURCE; <br /> Proposed Use of Building _ Ga��_ Electric Other <br /> Building type:XSinole Family ^Duplex_Townhouse _Mul -Family —Commercial <br /> Type of rolect: New Addition Remodel Repair T-1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(.,ddr a of space provfded on the back)' 1 <br /> ilo Q C.L. g 01S <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _Now„Addn Alteration_Ropalr 'type of Project, _New—Adds _Alteration_Repair <br /> show Number # of fixtures show Numbar of fixtures <br /> A)0—air handling units Toilet <br /> Forced air s stams Bathtub <br /> Gas pi ing Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8e,disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Ran2e hood Water heater <br /> Exhaust fan Sink servicefbarlrno /etc. <br /> Hcat pump eackilow preventer <br /> Unit heater Urinal <br /> Boiler DrInking Fountain <br /> Refrirgeration Floor drain <br /> WOMMOve Grcase trap <br /> Duotting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other-. <br /> I hereby certify(hpt I have read and examined this application and know fhr..-arae to be true and correct,All previsions of laws end ordinsncea goverhing Ihic Type of work wlil b9 comp <br /> h whether gpecitied herein or net.The granting of a pormit does not presume to give authority to violate,or cancel the prove;nn of any other state or local law regulating comoructlon <br /> Tho I nm nulhorizeC by the own r of thea property Iv perform the work for wnl n apple ?tlDn�5 mach end I comply With the 9tg1C GOn;mrrora Lew 19„'.7RG�N and 296,200a wnc. <br /> norlAuthor zed Agent Signature 2t9 (Revised 9/2014) <br />