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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 PERMIT# <br /> ll �`f 3 2G U ! �.) I: Vit..(-: <br /> LEGAL for new construction: Short PlaUsubdivision _7y ,LSG( � Lot No. (attach copy of long legal description) <br /> OWNER Al Z;� / Phone/E-mail <br /> Address City/State/Zip <. <br /> APPLICANT: Owner Owners Agent Contractor Contractors Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Z.S>` State Lic.# City Bus. Lic.# e'a0 <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 12/eVpo /ZIU <br /> 4-,04 40cH-/7Ge77 ' ?fro &z4'YZZZ <br /> 17` Phone/E-mail / <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building- HEAT SOURCE: <br /> Proposed Use of Building ��u Gas Electric Other <br /> Building type: _Single Family Duplex_Townhouse Multi-Family X Commercial <br /> Type of project: ' New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chante of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ..6w65roAc?' x.14O1/^-3.a)o Sf <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 airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower _ <br /> Gas fireplace Kitchen sink&disposal <br /> I Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.)— <br /> Heat <br /> service/bar/mop/etcZHeat 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: <br /> Number of Heads Other: <br /> I hereby certify that I have reada examined this application and know the same to be true and correct.All provisions of laws and ordinances goveming this type of work will be comp <br /> with wh er specif d herein o n t.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 /> T I am au by the <br /> Jeof 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 /> ner/Authorized Agent Sr nature Date (Revised 9/2014) <br />