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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRIN KLER/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 A R SS: PROPERTY <br /> r U t <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER C) d— ►' `I { •tS Phone/E-mall 35's - oq <br /> Address— CitylState/Zip -— <br /> APPLICANT:_Owner _Owner's Agent Contractor _Contractor's Agent _Tenant( u provide a letter of consent from the ovmer to dl rk In the space) <br /> CONTRACTOR State Lic.# K"1 Cit Bus. Lic.#bol d <br /> Address q 1,001 a I .N+ 'tcl B 1L,8 Phone/E41 �p •p�`i 8 • -4A Ob <br /> TENANT BUSINESS NAME CONTACT FOR PERMI <br /> Phone/E-mail W YY%*i-4.-GE'.') , C-ayn <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WO /3 OE) <br /> Existing Use of Building_. HEAT SOURCE: <br /> Proposed Use of B .Iding Gas Electric Other <br /> Building type: ✓ Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ofproject: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DECRIP ION OF WORK(additional pace provided on t back): l v f <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 pi ing 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 trio <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.Ali provisions of laws and ordinances governing this type of work will be comp <br /> 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 /> Thio I am authorized by the own r of this property to perform the work forich ap cation is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> ! Q 'R- <br /> nerlAuthori:ed Agent Signature I Cate (Revised 9/2014) <br />