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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 /> SITE ADDRESS: PROPERTY TAX# P RMIT# <br /> 1 � ( � �N �k ►+� i � ItIt r.- <br /> LEGALfor new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER _r vv S L--0,C Phone/E-mail q25-- Z -- c/ <br /> Address t Zl 5 w , t 1 •C City/State/Zip v r i / Do -� <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 = State Lic. # City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT E3U51NF,55 NAME CONTACT FOR PERMIT <br /> Phone/E-mail '-2 .�_— Gj / <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_T.I._Sign_Sprinkler Demolition _Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> r, C- 0env (�l V- nc� e � �� <br /> a <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 I Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> I Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan ( Sink(service/bar/mop/etc.) <br /> Heat pump j Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler I Drinking Fountain <br /> I Refrigeration I Floor drain <br /> Woodstove I Grease trap <br /> Ducting i Roof drains <br /> Other j 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 /> That 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 /> Owner/Authorized Agent S nature Date (Revised 4/2015) <br />