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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/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: ]PROPERTY TAX# PERMIT <br /> r <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:—Owner _Owner's Agent X—Contractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR r r GOn I State Lic. y City Bus. Lic.# "7 <br /> Address 0 l YW111 Phone/Emailmay, <br /> TENANT BUSI ESS NAME CONTACT FOR P RMIT 9 '1` Com <br /> �.a s> m arra J651(aVabr1)5a) <br /> Phone/E-mail Q <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0,�,CO <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.1. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> mo\ ow reads <br /> V,6(X.o (2) l� S <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 handlin2 units <br /> Forced airs stems I Toilet <br /> � Gas piping � Bathtub <br /> Water heater Lavato (wash basin) <br /> � Shower <br /> Gas fireplace � <br /> Gas rangelKitchen sink&discosal <br /> Clothes drver Dishwasher <br /> washer <br /> � <br /> Range hood Clothes <br /> Exhaust fan Water heater <br /> Heat pump Sink(service/bar/mop/etc.) <br /> Backflow reventer(inside bidg) <br /> Unit heater I Urinal <br /> Boiler <br /> Refrigeration Drinking Fountain <br /> Woodstove Floor drain <br /> Ducting � Grease tra <br /> Other Roof drains <br /> Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM I 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 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 /> qtluthorized by the owner 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 /> - o®suthorized Age t Signature Date ( Z <br /> (Revised 4/2015) <br />