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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#OOg3739Z64pf,2-;/ PERMIT# <br /> _3 1,21,037.3fza lei <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERPhone/E-mail <br /> Address '23/4 /77k-" City/State/Zip <br /> APPLICANT:_Owner X Owner's Agent _Contractor _Contractors Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR " (va ;1 ecm f State Lic.# City Bus. Lic.# Q o/G <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMITg/4o"12D MUg41=4GGI <br /> / Ady-44104-.4gL-y-v 7z—ns 71Yi d1�{YZZZ <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building &ada-f HEAT SOURCE: <br /> Proposed Use of BuildingGas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family X Commercial <br /> Type of project: New Addition Remodel Repair T.I. Sin Sprinkler k Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): tVA4YW <br /> f3!!14,W,cll�. <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 /> I A/C—air handling units Toilet <br /> I Forced airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> j Gas fireplace I Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood I Water heater <br /> Exhaust fan Sink service/bar/mop/etc. <br /> Heat pump Backflow preventer <br /> Unit heater 'JUrinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads j Other: <br /> I hereby certify that I have read a 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 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 /> =n.rlAuth.ri,.d <br /> by the ow a 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 /> Agent S'idnature Date (Revised 9/2014) <br />