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PERMIT APPLICATION <br /> BUILD ING/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 /> LEGAL for new consttuction: Short Plat/subdivision Lot No__ (attach copy of long legal description) <br /> QWNER � � Phone/E <br /> Address City[State/Zip �A D <br /> APPLICANT:_owner Owners Agent Contrac4or _C:ontract'es Agent _Tenant(mutt Provide a letter of consent from the own¢r to do won[In Ne BDece) <br /> ;CONTRACTOR State Lic.# ��I Cit Bus. Lic.#a d g 0 <br /> Address pI ! — Q Phone/Emair `D� S O� <br /> YENANT 13t1SINES NAME CONTACT FOR PERMIT <br /> Phone/E-mml� ( m'1-L,CC) LO <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WOR 1,;000 <br /> Existing Use of Building - HEAT SOURCE: <br /> Proposed Use of Building sas Electric Other <br /> Oullding type: _Pingle Family _Duplex_Townhousa �Multi-Family _CDmmercial <br /> Tyee of project: New Addition Remodel Repair T.I. Sin Sprinkler Demolitiorl Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> I <br /> fi,• r <br /> MECHANICAL PERMIT APPLICATION LUMBING PERMIT APPL4CATION <br /> Type of Project: _Newddn ,Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number of flxfuros Show Number(#)of fixtures <br /> AIC—air handling units Toilet <br /> Forced air Systems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> CGa5 fireplace Kitchen sink&dis osal <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 trap <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads Otlier: <br /> 1 hereby certify that I have read and oxamined this application and know the same to be true and correct.Ail provlaiene or lawe and ordinances governing this type of work will be comp <br /> whether specified hereln or not.The granting V 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 I Bm authorized by the own r of this property to pedofm the work for which application is made and I comply with the State Contractora Law 13.27 RCW and 296.200A WAC. <br /> nerlAuthonzad Agent Signature Date (Revised 9/2094) <br />