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PERMIT APPLICATION <br /> BUILD1 NG/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CIS OFWEREI ISERMES <br /> 3200 Cedar SL, Everett,WA 98201 425-257-8810 FAX 425-257-8857 www_everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: / I/ '/ ' �` PROPERTY TAX# P MIT# ti <br /> nim <br /> 12- <br /> LEGAL for new construction: Short Piatisubdiv�ision Lit No_ (attach copy of long legal description) l <br /> OWNER r L�y�l�? 7 �fJ/✓� -ys&E mai <br /> Address iState/Zip <br /> APPLICANT:_Owner _Owners Agent 14 ,ontractor _Contractor's Agent ,_r Tennant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR ( f >�� Ct)/E�Bus.Lic.# <br /> Address - <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ir <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATIONCONTRACT PRICE OF WORK 7,2, I Ulf <br /> Misting Use of Building LAp HEAT SOURCE: <br /> Proposed Use of Building tl �IkZ�l45�� Gas X 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 ORK(additi nal space provided on the back): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addy, _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 Bathtub <br /> Gas piping Lavatory(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 neater <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 authori 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 /> ertAuthorized Agent Si Date <br /> (Revised S/lt)i?) <br />