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1I4ERMIT APPLICATIC � <br /> BUILDING/MEC HANICAUPLUMBI NG/SIG N/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 ADDRESS: 5 PROPERTY TAX# Pg RMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ) <br /> OWNER i)f� 4!� A-tA fZ p) ��t ✓)��'� Phone/E-mail J 1 2 J � 5 �3 ZA Gn�/ ! ,�h �nn C� •r1c � c <br /> Address P j-A L City/State/Zip V t lZC LOA <br /> APPLICANT-;,4 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 CV f State Lic.# City Bus. Lic.# <br /> Address I Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 2Q[14l C) r <br /> Phone/E-mail e P, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK '(0Z <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 <br /> `` (additional space provided on the back): I + <br /> Oir Cf <br /> {LL) Locb-3 -I�I ir..p 96k r(&\-JtJ Ul D� <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 air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater I 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 /> I 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 auth ized by the owne f 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 /> Owner/ uthorized A nt Signature Date (Revised 4/2015) <br />