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FEINT APPLICATL=44 <br /> BUIL®ILIOIMECHANICALIPLU B1NG/SIGN/SPRIN LER/DEMOL-,I` ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., 'Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SI E ADDRESS: PROPERTY TAX# PERMIT#' 1 J ^ <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of Ibng legal description) <br /> OWNERPhone/E-mail <br /> Address (�� ,� L + City/State/Zip _ e , ? <br /> �f�+. <br /> APPLICANT: Owner _owner's Agent xContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR State L'Ic.# cC4--XMP&LW City Sus. Lic.# p5 <br /> Address f Phone/Email�C`t,,, vi`[c� v'� .� !C�- tai <br /> CONTACT FOR PERMIT <br /> �d(c �(n C�C�O VCrvto.� Cvv��selforTj <br /> Phone/E-mail V,'c' :, (o;- ' y+ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE of WORK_ �,c e:o <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—T.I._Sign_Spdnkler_Demolition_Change of Use <br /> '—iil� DESCRIPTION OF WORK(additional space provided on the back): <br /> 1vtsl- I( cc�av►Srino.h'®n r`rc c,(arV,� gas s���r,cssr'v.� S1tS�l�t In vee , ) C_1 Sce—Acer (`oc,,,f <br /> JfFC- fZ5 gf,s sysk w�, <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ew_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 DuctingI 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 compiled <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 She 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 /> �� f?tel L Z L4,e <br /> Date (Revised 4/21715) <br /> z wner/Auth ed Agen Signature <br />