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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 /> SITE ADDRESS PROPERTY TAX# P RMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER �Y ,e, y' Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner —Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letterof consent from the ownerto do work in the space) <br /> CONTRACTOR State Lic.# G 4qUCity Bus. Lic.#031397 <br /> Address -ow3 L Phone/Email noz W <br /> TENANT BUSINESS NAME C NTACT FOR PER <br /> rlCr IS- J �g1a <br /> Phone/E-mail �r 1 .�D <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Ola- <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. Sin xsprinkler Demolition Chane of Use <br /> DESGRIPTION OF WORK(additional space provided on the back): <br /> C2) &Tr)ni::-ier YDS <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 pipingLavatory(wash basin <br /> Water heater Shower <br /> � Gas fireplace � Kitchen sink&disposal <br /> Gas range <br /> Dishwasher <br /> Clothes dryer <br /> Range hood Clothes washer <br /> Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pumpBackflow reventer inside bldg) <br /> Urinal <br /> Boiler Drinkinq Fountain <br /> Refrigeration Floor drain <br /> Woodstove <br /> Ducting � Grease trap <br /> Roof drains <br /> Other I 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 /> That I am authorized 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 11 uthorized Age t ture , •Date <br /> (Revised 4/2015) <br />