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• • <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS:/' �� iCa 1�n n ;^!)� _��, PROPERTY TAX# PERMIT# <br /> cis`}- \ v L 5 1 3 f I - <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER `-C(-VY-)Cv 1 " \�i Phone/E-mail �lv (;"Al j <br /> Address City/State/zip L LA N C) . 1. <br /> L J <br /> APPLICANT:—Owner _Owner's Agent -Contractor _ContractoOrs Agent Tenant(must Provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR eGi"l S jCtiYIS L&I Lic.# L. (✓ `� ICO,E Bus. Lic.# <br /> Address (---c .c(1 '? \ <' : 1 C c1 -��l-DPhone/Email L'4-)s."50 ' l!1 L--' <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING ,PERMIT APPLICATION CONTRACT PRICE OF WORK i ,cx)O • or) <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 /> �i V C G���4� <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 /> 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 goveming 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 1 am authorized by the owner of this property to perform the*ork 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 Date (Revised 6/2012) <br /> ` I <br />