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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEIIAOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.evertDttwa.org <br /> SITE ADDRESS: _ PROPERTY TAX# PE1?i lT,# <br /> -013 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER .ew � M L MCA/AM Phone/E-mail LIA--(6M <br /> Address 1W HO?T AW City/State/Zip Eye'(4)1 WA NJ U <br /> APPLICANT:4 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 I�J r'! State Lic.# City 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 7071 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building/1 cC `0 y Gas Electric Other <br /> Building type: Single Family Duplex_Townhouse _Multi-Family Commercial <br /> Type ofproject: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> nnuo I1 Y 5 F2 r>r t+� �ccE550r�y g�ic o tti c PQtan 70 Nc--� Ss I�_ FtNa� tr�SrEcrtw,v ni r�t�vp� 00 <br /> Prar,tr,- 'At c 1503-01e, <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 I Kitchen sink&dis osaI <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: <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 camp <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 /> i <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) t <br />