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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www•ever���9 /3 <br /> SITEADD � PfiOPERTYTAXp PERMIT# � <br /> �2 � � <br /> LEGAL for new conslruclion: Shot�Platlsubdivision <br /> Lol No._ (attach copy of long legal description) <br /> OWNER Phone/E-mail � <br /> Address CirylStale/Zip <br /> APPLICANT: Owner OwnefsAgent _Conlraclor � onlractor'sAgen� T2f1801(mus�pmNtlealetterolwnsentlmmNaowoertodowotkinNespace) <br /> CONTRACTOR ��/1� <br /> L— Stale Lic.# City Bus. Lic.# <br /> PhonelEmail <br /> Address <br /> TENANT BUSINESS NAME I CONTACT FOR PERMIT <br /> �( l�Y"� if � �C y�"��l PhonelE-mail <br /> SUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> HEAT SOURCE: <br /> Existing Use oF Building <br /> Proposed Use of Building Gas_ Electric_ other_ <br /> Building lype: _Single Family _Duplex_Townhouse _Mulli-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(edditional spaceprovidedon thebackl: <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProfoct: _New_Addn _Al�eretlon_Repalr TypeofProjoct: ShowNumber(N)o/�ixfu`res`ton_,Ropalr <br /> ShowNumber(#)o//ixfures � Toilet <br /> A/C—airhandlingunils � BathWb <br /> � Foreed air syslems Lavatory(wash basin) <br /> ( Gas piping � <br /> Waler heater Shower <br /> Gas freplace I Kitchen sink&disposal <br /> Gasrange � Dishwasher <br /> I Clolhes dryer I Clothes washer <br /> Range hood � Water heater <br /> � Exhaust fan I Sink(service/bar/mop/elc.) <br /> � Heal pump i Backflow preventer <br /> � Unit neater I Urinal <br /> � Boiler I Drinking Fountain <br /> � Refrigeralion I Floordrein <br /> Woodslove I Grease trap <br /> Ducting I Roo(drains <br /> � Olher � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Numbero(Heads � Other: <br /> I hereby cenily lhal I havo read and examined Ihis application and know Ihe samn to be Imo antl mrred.All pmvislans a�laws and ortlinances goveming this typa olwork will be wmplied <br /> v;�,fh whether specifed herein or not.The gmnling ol a permit tloes not pmsume lo give autnority to violale or wncel lhe prvvision ol any alher stale or local law reguletin9 construction <br /> Thal I am � ed by Ihe owner ol lhis pwpehy lo pedortn Ne work for��hich application is matle and I comply with iha State Conlradors Law 18 27 RCW antl 295200A WAC. <br /> �"� �,���-- �._�z: 1� <br /> (/ Dale (Revisetl32073) <br /> Ownor Jluthorized Agu nt Siyna W re <br />