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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: �7 POP <br /> RERTY TAX# PE� IT# <br /> LEGAL for new construction: Short Plattsubdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address LL4 City/State/Zip WA <br /> APPLICANT:_Owner _Owner's Agent Xcontractor _Contractor's Agent _Tenant(must Provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 1 tr1 State Lic.# KIM�;614 10(J"( ACity Bus. Lic.#('N <br /> Address (f I Phone/Email -( <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E- - t� J <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 ofproject: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <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 /> f 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 <br /> 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 /> 9 <br /> I h reby certify tha ave reap and examin0tp thigappli tion and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be comp <br /> v�h wh her spe ed here i or not The g nti of a and does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> pt I authorii#d by th owner di this p to orm the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br /> 4 r J l <br /> caner/Au orize A e Si ature Date (Revised 912014) <br />