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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 ADDRESq• PROPERTY TAX# <br /> PE' IT • II • <br /> .7z/it 4/Nt r �2. -444' ©l7s - �/Z)D��(.� )S3 t6/r ) l - 0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> C"�i- ns <br /> OWNER /9Oe�J1/41/6 ,40/7-#4,e,,,, 4 Phone/E-mail /Z j�,. 5Z 2. �- <br /> Address �c,/y/ /J � 7 City/State/Zip <br /> ' 9ffzc9 <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 /> 77 <br /> CONTRACTOR C" y�'t State Lic.# City Bus.Lic.# <br /> Address /Phone/Email <br /> TENANT BUSINESS NAME �- CONTACT FOR PERMIT <br /> Phone/E-mail 5/ .5"-:5-o6''',�•o?t> /ooft'Fv C'ra'!. ttj� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK . <br /> Existing Use of Building J HEAT SOURCE: <br /> Proposed Use of Building Gas ,lectric 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 /> (1,4�6'� <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 Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> nNumber 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 Irit'on by t,-.wner 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 /> oe <br /> J <br /> Owner/Auth r Agent Signature Date (Revised 9/2014) <br />