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%ERMIT APPLICATICAl <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SP RINKLER/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 OG� a-�O P <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER J (,VL 4eW50,J Phone/E-mail <br /> Address 0PQ�f� 21 p City/State/Zip 61/Cg-r-rT A <br /> APPLICANT:—Owner _Owner's Agent xContractor —Contractor's Agent _Tenant(must provide a letter of consenl from the owner to dp work In the space) <br /> CONTRACTOR DAY d .. Lk State Lic.#D �T7,0tf-qLJtJ1EQ City Bus, Lic.# Olq-7L4 <br /> Address ' • LU W c7W37 Phone/Email <br /> CONTACT FOR PERMIT 'j <br /> Phone/E-mail 4ZJr—�7j�—�p��p <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �I33.aD <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electrick Other_ <br /> Building type: XSingle Family _Duplex_Townhouse —Multi-Family _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): NST/{ tiJP�1 (�(tiGT�D�DhtCT LESS <br /> �t-I- Yut� SYS 7er� <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 air systems 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 Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> I 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 complied <br /> ewth 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 /> ThattI am au ed by the owner of this erty to pe the work for which application.s made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 1! <br /> Owner/Au z d Agent Signatur Defte (Revised 4/2015) <br />