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PERMIT APPLICATIGN <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 ADDRE S: PROPERTY TAX# PERMIT It rr <br /> LEGAL for new construction: Short—PA/subdivision Lot No. (attach copy of long legal description) <br /> r <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:—Owner _Owner's Agent -veontractor —Contractor's Agent —Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR ,f��fGr/�Q� ry EState Lic.# City Bus, Lic. #032M Address Phone/Email <br /> . = <br /> TENANT BUSINE55 NAME �a.S=alp gtf� <br /> CO TACT FIT <br /> 4a ,�f � / <br /> o� �!/�ll� Phone/ -mail c��'�dyc?,3BtfI <br /> BUILT—DI'N'G 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 of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> `&AI ew � p/fico <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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> I Refrigeration Floor drain <br /> Woodstove Grease trap <br /> ! Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads I 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 wheM 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 a a ihoriz by the owner of this property to perform the work for which application its made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC, <br /> OtNner6Authorized Agent Signature Date (Revised 4/2015) <br />