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BUILDING/MEC NICAUPLUMBINGISIGNA :MKLERIDEMOLITION <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 /> Z S _� �.:, e: DD r ooj�oUov1 LA <br /> LEGAL for new construction: Short Plat/subdivision Lot No: (attach copyoflong legal description) <br /> OWNER 4: /G40W' f7o /�/� 111lJTyd Phone/E-mail �G a , <br /> Address? �dX �j z City/state/zip� /e <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 N,OG/9 State Lic.# C>(�.� tc11(7 I Z City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT <br /> /fBUSINESS <br /> NAME CONTACT FOR PERMIT , A/,p..y ,/�F-� <br /> y /� Phone/E-mail 2� � J 7 6 6,7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK oO d, 00 <br /> Existing Use of Building J�i�iC/� HEAT SOURCE: <br /> Proposed Use of Building �/�/� Gas_x Electric Other <br /> Building type: ,_Single Family _Duplex Townhouse _Multi-Family _Commercial <br /> Type of ro'ect: New Addition Remodel Repair T.I. Sigh Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <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 /> 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 inside bid <br /> Unit heater Urinal <br /> Boiler Drinki-ng 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 I I Other: <br /> I hereby certify that I have read and examined this applicatlon and know the same to be true and correct.All provisions of laws and ordinances governing this type of work wm be <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 constr <br /> That I am authorized t the owner of ^Is 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 /> Owner/Authorized Agenf Signature Date (Revised 4/20• <br />