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0 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: PROPE�JY TAX#. PE IT# <br /> LEGAL for new construction: Short Plat/Subdivision Lot No. (attach copy of long legal description) <br /> OWNER 111 \`� I <br /> hone/E-mail <br /> Address I c °� � l �k " C J'� �!(^ ity/State/Zip F-Ve 4 L l \ ����'✓� <br /> APPLICANT:_Owner _Owner's Agent Contractor _Contractor's Agent p_�Tenant(must provide a letter of consent from the owner to do work in the space) <br /> ( <br /> CONTRACTOR `"}� I I I i, State Lic.# ��®(a( City Bus. Lic. <br /> 2y� titi L 22 <br /> Address � Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> CAwe-k- �"CAI�1���tll�(�,�� <br /> Phone/E-mail C^") 2�(c; <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Z 1 cif <br /> l _ <br /> Existing Use of Building HEAT SOURCE—- <br /> Proposed Use of Building �� Gas' Electric Other_ <br /> Building type: ✓Single Family _Duplex_Townhouse _Multi-Family _Commefcial <br /> Type ofproject: New ✓Addition Remodel Repair T.1. Sign_Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the ba <br /> CXGCi <br /> �A 'o , <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 <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM I 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 co rect.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 owner ci this property 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 /> Owner/Authorized Agent Signa a Date (Revised 9/2014) <br /> Z <br />