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PERMIT APPLICATION <br /> BUILD1 NG/MEC HANICAL/PLUMBING/SIGN/SPRINKLEWDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITEADDRE PROPERTY TAX# _ PE MiiIT <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy!!of long legal description) r. _. <br /> OWNER ` l_!yt e(_�C Phone/E-mail Z C. `C� ov.C�u CG�cCIL. <br /> Address ( `�� -- -�� , �� `• -j City/State/Zip c �� <br /> APPLICANT!LOwner _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 L&I Lic.# COE Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family 4 Commercial <br /> Type of project: New Addition Remodel _Repair_T.I._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF VVORK(additional space provided on the back): _ <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 <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: 1 C-*- <br /> Number of Heads Other: <br /> 1 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 perm't 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 ow property to pert the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> - s 2- �3 <br /> Owner uth ized Agen re Date (Revised 6/2012) <br />