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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/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 <br /> SITE ADDRESS-,, ,)(, PROPERTY TAX# PE IT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail 9-!M--13 -1 <br /> Address City/State/Zip ` <br /> V- Vr�� � W Z <br /> OWK <br /> APPLICANT:—Owner _Owner's Agent )(Contractor —Contractors Agent —Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR �( �Q pit\• ` t, rL&I Lic.# COE Bus.Lic.#.6371169 <br /> Address <br /> Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT S tt fl A CA- <br /> Phone/E-mail -Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK A k 5 3 .O° <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Cas Electric_ Other_ <br /> Building type: Single Family _Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project: _New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additionl space provided on the back): ' C <br /> t U f fell Loev-v y 'rob 'k <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 /> f Forced airs stems 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 heater <br /> 1 Exhaust fan { Sink(service/bar/mop/etc.) <br /> Heat pump i Backflow preventer <br /> Unit heater ( Urinal <br /> Boiler i Drinking Fountain <br /> Refrigeration Floor drain <br /> 4 Woodstove Grease trap <br /> i Ducting Roof drains <br /> j 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 constriction <br /> That I am authorized by the owner of this piopeiiy to perform the work for which application is made and I comply with the State Conlractars I..aw 1827 RM and 295.200A WAC <br /> 5�wnerIALJthorized Ager re Date (Revised 6i2012) <br />