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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# PERMIT# <br /> � <br /> 02 f 6 n /i 1, ��y 3�q ) 9ob w Vero GI — <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER k 0_ A(/)^P r Phone/E-mail rZ5 Z ?9:26/ <br /> Address .1 b p 1.1-er rwlAr F, 4 City/State/Zip 144 fv /�7 P://41: 7 f 2.7 / <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 &wrap. State Lic.# City Bus. Lic.# <br /> Address 7Aj ) // ,"erA :[.t in rTA Phone/Email <br /> TENANT BUSINESS NAME / CONTACT FOR PERMIT <br /> 19/41'7 <br /> ►-r /7 -19a/ 91 <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. Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> rpS/ 1(0 ) CwsJcuLrP-7 fdN ro 0ei a...MtN cc ,eevt (L J1rS rib <br /> L-efc 70-6 113vt itflI!JL AWL tPcGAN7 AN 5A- Fe <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 <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> Ducting JRoof drains <br /> Other Medical Gas <br /> SPRINKLER / 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 correct.All provisions of laws and ordinances governing this type of work will be complied <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 /> / <br /> OwnerAuthonzed A ent Siyure Dat <br /> (Revised 3/2013) <br />