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IERMIT APPLICATIC <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# P RMIT# <br /> oo _ oojv000v >oc <br /> LEGAL for new construction:�Short Plat/subdivision Lot No: (attach copyoflong legal description) <br /> OWNER 4�e�; F� f70�f//�jj AC�Ty Phone/E-mail �2 57 O , Z Z Z, <br /> Address?--f�dX 1 lCity/State/Zip f4e;ee71— 7,!5>1- <br /> APPLICANT:X Owner —Owner's Agent _Contractor _Contractor's Agent _Tenant(must prov de a tatter of consent from the owner to do work In the space) <br /> CONTRACTOR Nv�A State Lic.# k l I(7'1 z City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ��p Y �E-LT��— <br /> Phone/E-mail 2 S—2 �r6 6.-f — ��� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /ADO, av <br /> Existing Use of Building s/c�e HEAT SOURCE: <br /> Proposed Use of Building_ 514 Gas X 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 rovided on the back): <br /> I� <br /> MECHANICAL PERMIT APPLICAT16N I 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 /> GasPiPing Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Ran a hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat Dump Backflow preventer inside bid <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refiricieration Floor drain <br /> Woodstove Grease trap <br /> Ductinq 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 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 t le owner f this property to perforin the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> /v J <br /> Owner/Authorized Agerif Signature Date (Revised 4/2015) <br />