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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ®O <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> F 212 - <br /> LEGAL for new construction: Short P lat/s ubdi vision _Lot No. (attach copy of long legal description) <br /> OWNER UAv /t2/1-ePhone/E-mail <br /> Address a1#2LI 4 u I � Avt City/State/Zip 7 <br /> APPLICANT:$Owner _Owner's Agent _Contractor _Contractor's Agent Tenant(mustprovide a letter of consent from the ownertodoworkin the space) <br /> CONTRACTOR O L&I Lic.# COE Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FO f P��� S <br /> JAv, //vim L1 <br /> Phone/E-mail - -� 7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK O <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building / Gas_ Electric_ Other_ <br /> Building type: �L_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 /> UAle- � ��S /Kt p1,Y t e� f !L <br /> �u<- <br /> S �Fklr AcN S� Z � X �11 - E=,%v, W4,L 4-S�/16 j , <br /> — - -) w dl�,X)t 1--i e er- Pf <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 air systems X, Bathtub <br /> 'L Gas piping Lavatory(wash basin) <br /> ( Water heater Shower <br /> Gas fireplace I 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 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 /> \12— <br /> Owner/Authorized Agent Signature ate (Revised 6/2012) <br />