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PERMIT APPLICATION <br /> D <br /> BUILD1 NG/MECHANICAL/PLUMBI NG/SIG N/SPRINKL D51"N <br /> CITY OF EVERETT PERMIT SERVICES �T T T TT�� <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wp"xa�tJC.0W0RKS <br /> SITE ADDRE S: 70,710,DqO050077, <br /> MI <br /> ILp-,OL C-"-\�- <br /> 1 ?- <br /> LEGAL for new construction: Short Plat/subdivision Lot No.--S-- (attach copy of long legal description) <br /> OWNER Phone/E-mail2 <br /> Address ��7 � ,�� w:�1! City/State/Zip n,K / WA <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 C 1112tate Lic.# C11A i Offl OG City Bus. Lic.# <br /> Address 1 Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> L M t-l' v rj �C/�C Phone/E-mail '')L L& `Tl <br /> —7 0 7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 2 i KGt <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric_ Other_ <br /> Building type: _Single Family Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> /`j <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: NewAddn _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 <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 comp <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 Slate Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized gent Signature I pate (Revised 9/2014) <br />