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PERMIT( APPLICATiUN <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/®EMOL�TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.ev�ere;a org <br /> " �- —�t; <br /> SITE ADDR S: PROPERTY TAX_# PFRMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach/copy of Ibng legal description) <br /> ij L(C Phone/E-mail f �6 C C <br /> OWNER ►�`' '" '" t <br /> Address 14 City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent _Contractor —Contractor's Agent —Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR I/�1y w 9/ State Lic.# City Bus, Lic.# <br /> Address Phone/Email <br /> TENANT BU-51NESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE of woRlc C <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 Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Nati^' <br /> �/ r�8'►Y1 / ?Prc,l�h�� 7� Lx►S7cNL S -r/�Uc-Z <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Adds _Alteration_Repair Type of Project: _,New_Adds ,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 /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I 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 All provisions of laws and ordinances governing this type of work will be complied <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 /> That I am authorized bya 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 ner/Authorized Agent Signatur Date (Revised 4/2015) <br />