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BUILDING/ ECHANoCALIPLU BI�IGISIGNISP IIAKLERI®EM©LITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.arg <br /> SITE ADDRESS: ROPERN TAX# PERMIT# <br /> LEGAL for new construction: Short Piat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER p - 1 Phone/E-mail LI25 '- <br /> Address ` - — Z0( City/State/Zip Jf I/Q_�ii t� ui <br /> APPLICANT:_Owner _Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR State Lic,# City Bus. Lic.# <br /> Address Phone/Email <br /> CONTACT FOR PERMIT <br /> � y —0c> <br /> L-'L-C-1 Phone/ mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE of woRK <br /> Existing Use of Building %A- HEAT SOURCE: <br /> Proposed Use of Building , n- �>; Gas_ Electricg other <br /> Building type: _Single Family _Duple _Townhouse _Multi-Family �Commercial <br /> Type of project: New _Addition _Remodel _Repair T.I. Sign_Sprinkler_Demolition Change of Use <br /> DESCRII�P+TION OF WOR/IK(additional space provided on the back):� � ,��// �- yL p rnffJ�S jy Q �/J�ih�, <br /> -Z , <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 air systems 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 bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> i Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I 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 complied <br /> with whether sp ified herein or not.The gra ting 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 aut ed by the r of this p petty to perform the work for which application is made and I comply with the State Contractors Law 1627 RCW and Z9620nA WAC. <br /> (Revised 4/215) <br /> Owne/Authorize ent Si nature Dae <br />