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• 0 <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: \ PROPERTY TAX It PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision— Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail - — <br /> Address lA Q• City/Stale/Zip )44 Lk,) <br /> APPLICANT: Owner _Owner's Agent Contractor _-Contractor's Agent Tenant(must provide a letter of consent from the ovnor to do work in the space) <br /> CONTRACTOR c State Lic.# A q - dy Bus. Lic.# C <br /> Address )WI t Phone/Email <br /> TENANT BUSINESS NAME C NTACT FOR PERMIT <br /> Sit <br /> Pho e/ mall //\\ ,\ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK VU I Q V <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 ofproject: New Addition Remodel Repair T.I. Sin_Sprinkler_Demolition Chane 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: _New_Addn _Alteration_Repair <br /> Show Number(#)o lxtures 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(his 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 auth rized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 16.27 RCW and 296.200A WAC. <br /> Owner/Authorized Agent Signature IDate (Revised 9/2014) <br /> CG <br />