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PERMIT APPLICATION <br /> BUILDING/MEC HANICAL/PLUMBING/SIG N/SPRIN KLER/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: s PROPERTY TAX# PERMIT# <br /> • �+- ,r �r r zrs�t (� -7 5 3()8Od70Ca <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) �^ <br /> OWNER Phone/E-mail <br /> Address 110 &t &(A q9W( ty/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 .u. State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT (go J-c—, <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: _�C 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): ,t <br /> 1!r�^ l ovl ( ��r1��,17 �Cl7 ( - w mA e.i'"�C1.. �.-,ill�r�l n'' �11• <br /> V <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 s? Lavatory wash basin <br /> t Water heater d , Shower <br /> Gas fireplace (i Kitchen sink&disposal <br /> Gas range ` fl Dishwasher <br /> Clothes dryer 1 Clothes washer <br /> Range hood <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: Wt1t �e rvi Lc- <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 comp, <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 own of this property to perform�ork r which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br /> t <br />