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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRc PROPERTY TAX% PERMIT# <br /> 5-A OC)501-5-4 _ .3c <br /> LEGAL_for new construction: <br /> jShort <br /> tPlaUsubdivision Lot No.,S (attach copy of long legal description) (� <br /> OWNER �ci `� l� Phone/E-mail i � 5 <br /> Address �1�� —l— �js� �} `dj City/State/Zip <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 L&I Lic.# COE Bus. Lic.# <br /> Address Phone/Email y < A m�Ytd c. j ' � l =✓-V�C��'�V1 9C- <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT [S ® e Y i/y <br /> VA) s ..35-y- �� � <br /> Phone/E-mail , APP, <br /> BUIL01N%G• PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use Of Building_ r���Y�c�s HEAT SOURCE: <br /> Proposed Use of Building. i ` 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 <br /> ,_Change <br /> of Use <br /> DESCI�IP�ION OF WORK(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 I Clothes washer <br /> Range hood j 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 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 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 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 /> �t 6�. <br />