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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: �,� r, PROPERTY TAX# PXRMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER `x-�Q1�NJ rj ` _D Phone/E-mail <br /> Address C`j2.I t CP PL. 14 City/State/Zip a,F Tr l paw ZU� <br /> APPLICANT: Owner _Owner's Agent Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR k (W 7State Lii,c^.# -Ci L} C j_ City Bus. Lic.# <br /> Address =� '�� }—[( t �3 5-r r (.�,�(C� ���( /li'o Phone/Email <br /> TENANT BUSINESS NAME T CONTACT FOR PERMIT <br /> f-W M VZ464A � r�=�,gems, <br /> Phone/E-mail 2"--Jib 0)1 (� t��[ �f6����i'. '1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �I ® <br /> Existing Use of Building i�7 'I& - ( $, h HEAT SOURCE: <br /> Proposed Use of Building � 1����/itl— ��i �.1 Gas Electric_ Other <br /> Building type: Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> gepNrp- oF- ibis- -� 'Pel. F-P- !Ai4 DUE -i?�> Frizt 47f"tM1"A ;E: <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 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 /> 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 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 /> Owner/Authorized Agent Signature Date (Revised 4/2015) <br /> t 4 2 , <br />