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c►-�51 1 <br /> PERMIT APPLICATION <br /> BUILDING/MEDHANiCAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-881+) FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: °ROPERTY TAX# PE MIT <br /> p i l �-- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ) <br /> OWNER LC�111�y�/State/Zip <br /> Address p <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 1\ �t�� 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 <br /> Existing Use of Building HEAT URCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _ uplex_Townhouse _Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair—T.I.—Sign_Sprinkler_Demolition Change of Use <br /> I u�.�t+ivr r rvi• yr YvORUK(aduiiionai space provided on me bac ) <br /> ro 0 6 r <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Ty of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–air handling units I Toilet <br /> j Forced air systems Bathtub <br /> I Gas piping Lavatory(wash basin) <br /> ter heater j Shower <br /> Gas ' eplace Itchen sink&disposal <br /> Gas ra e Di washer <br /> Clothes dryer j Clotheks washer <br /> j Range hood Water h ter <br /> xhaust fan J l, Sin (serve /bar/mop/etc.) <br /> eat pump ! Be flow pre nter <br /> nit heater U in I <br /> Boiler 1 n g Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> j Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j 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 complied <br /> with whether specified herein or ot.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 authorize y the o er 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 /> Owner/Au horized Agerit Sign to (Revised 3/2013) <br />