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PERMIT APPLICATION <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: .� i � PROPERTY TAX# PERMIT# =��� <br /> !Y <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent Y–Contractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTORBus. Lic.# <br /> Address`C �OlC�� \r��c�Q \v� � Phone/Em �a A\ /� • <br /> TENANT BUSINESS NAME CONTCT ER PER <br /> T <br /> Phone/E-maildLy –V\, Q <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: _Single Family _Duplex Townhouse _Multi-Family -)�Commercial <br /> Type of project: New Addition Remodel Repair Y T.I._Sign_Sprinkler_Demolition Change 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_Add n�Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–air handling units [ Toilet <br /> Forced air systems I Bathtub <br /> Gas piping Lavatory(wash basin) <br /> I Water heater Shower <br /> M Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> j Range hood j Water heater <br /> 1 Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> I Refrigeration I Floor drain <br /> j Woodstove Grease trap <br /> j Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> I 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 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 /> at I am authorized by the owner 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 /> :�I C <br /> Owner/Authorized Agent Signature Date (Revised 6/2012) <br />