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• • <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 /> SITE ADDRESS: 7 <br /> 7Z d ��/��j�17/L � PRTY� PERMIT#1 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long lega:description) <br /> OWN ER � rc <br /> ��ss •— FSA <br /> Address i� City/State/Zip4 <br /> APPLICANT: 1,"."(Dwner _,�1Owner's Agent Contractor Contractor's Agent _Tenant(mustprovide a letter of consent from the ownerto do work in the space) <br /> CONTRACTOR /�/�[ State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> IV <br /> Phone/E-mail J3'�V /�Ctir>ot/ E`E�P/�1, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Z J 0, <br /> Existing Use of Building �/` HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric V Other_ <br /> Building type: _Single Family Duplex_Townhouse Multi-Familyi_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 /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _,New_Addn _Alteration_Repair Type of Project: _hew_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–airhandlin units Toilet <br /> Forced air systems _ Bathtub <br /> Gas piping Lavatory wash basin <br /> _ Water heater _ Shower <br /> Gas fire lace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryerClothes 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 compl <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 /> Thatrau d b e owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW arid 296.200A WAC. <br /> / <br /> Owner/Aut ted Acent Signature Date (Revised 9/2014) <br />