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I&ERMIT APPLICATI09 <br /> BUILDING/MECHANICAL/PLUMBIN G/SIGN/SPRIN KLER/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: fj' PROPERTY TAX# PE MIT# <br /> 0 Z)Z_L;,j T <br /> LEGAL for new construction: Short Plat/subdivisiion�- Lot No. (attach copy of long legal description) <br /> OWNER �(�`JYrt.I +'.1+ht. L� Phone/E-mail � o (, <br /> Address (��iLl �Je' I►y�'{[' �� 3 CJ City/State/Zip Sev6`t wA -IS i b b <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 '-r `'� � � e�`f f State Lic.# <l� (U-154I2' City Bus. Lic.# f) j <br /> Address Gi� �F✓'� I�� '�li"'e u'� � Phone/Email �vV e 03 `i <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT � � <br /> vV relit cm, <br /> r Phone/E-mail '��' +" 1 i`I`1 �Rn-L4 i �vcftir+cnh✓��.ao. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space providedonthe back): <br /> (, <br /> L[) U1 lC I t ((M.v �1-5 �^1)- t" t� <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 /> t Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> 4 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 State Contractors Law 18.27 RCW and 296.200A WAC <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />