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WRMIT APPLICAT104 <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 /> SIS ADDRESS: PROPERTY TAX# PE MIT#� <br /> Sl1d i1 )1-4 17J C e LJC 0D C Z7-6000 �6d ,��' , -- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERr Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT: Owner ?�Owner's Agent Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR AA �—C 0 rCG�iG eKAto Lic.# City Bus. Lic.#a-Pili at <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Lye riac INLZQA1 b 1// CHI Sr Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building u rcb HEAT SOURCE: <br /> Proposed Use of Building c-h\,ktzJ ~ Gas 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 WO�RICr(additional space provided on the back): p <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 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 /> Exhaust fan Sink service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler rinking Fountain <br /> Refrigeration Floor drain <br /> I 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 Ihave xamined t application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be compl <br /> with whether sp ed herein o not. he nti -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 orized by the own roperty 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 /> y-- <br /> A011 7 <br /> n.unor/e..46nrron nonF cin naf...0 /S I naly 1p—i-4 APWI1 FI <br /> �c <br />