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iC� (�QC�Io <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 /> SITE2Dr ��� PROPERTY TAX# P RMI # - <br /> U CI 0 t� r <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER �y J Phone/E-mail �C c <br /> Address �/ City/State/Zip <br /> APPLICANT:._Owner _Owner's Agent Itractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> J <br /> CONTRACTOR ,y State Lic ;t enLlan-� ��y Bus. Lic.# �j2 <br /> - <br /> Address 1C)D Q a L` Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Ph U0 Q <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 of project: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> vtv �a aS � ,gyp �r p�plCr rQ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Add _ eration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number of fixtures Show Number #)of fixtures <br /> A/C—air handling units i Toilet <br /> ( Forced airs stems Bathtub <br /> Gas pipingLavatory 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 pumpBackflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> DuctingRoof 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 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 /> Tha.tJ,Nn awtlaQnyed by the owner of this pr to erform the work pplication is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200A WAC. <br /> Vw6er/Authorized Agentz <br /> atureIDate <br /> 9 (Revised 9/2014) <br /> 1 <br />