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PERiVIIT APPLICAT'ION <br /> �UILDING/MECHANICAL/PLIJMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF E�/ERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITEADDRESS:. .� �.. - ' �__,_ PROPERTYTAX# P I # <br /> G- ,� %/��r" ✓/- U���{s�Zovivvv v� �� � -CifS2� <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legai description) <br /> OWNER������ , Q����'�� �� 0 �'f Phone/E-mail �� �,� � ����� <br /> Address C.� �7� /�j�y City/State/Zip ��- v ��,�� <br /> �� 7 �� i � <br /> APPLICANT:�Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(musi pro��de a ien=r otconsenctrom cne o�yner to dc�h-o;k in tne sPace) <br /> CONTRACTOR ���� State Lic.# City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT s—�- <br /> �f � �/y <br /> � �" Q�.� /����� <br /> ��<!�����C [��� s-� <br /> Phone/E-mail/li `>. 7L�`✓�, �j��� ��7�(�/��������-/,n� ' <br /> BUILD{NG PERMIT APPLfCAT10N CONTRACT PRICE OF WORK �'�! <br /> �'�..�. .�-� <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 Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> L///'/"��� f/�� �"����/< ������i <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 handlin units � Toilet <br /> Forced air systems Bathtub <br /> Gas pipin Lavatory(wash basin <br /> Water heater � Shower <br /> � Gas fireplace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes dr er Clothes washer � <br /> Ran e hood Water heater <br /> � Exhaust fan Sink(service/bar/mop/etc.) I <br /> � Heat pump Backflow preventer � <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap I <br /> I Ducting Roof drains <br /> Other _ Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: ' <br /> Number of Heads Other: <br /> I <br /> I hereby certify that I have read and examined this application and know the same to be lnte and correct.All provisions of laws and ordinances goveming this type of work will be compl i <br /> with whether specifed 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 a th ed by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 1827 RCW and 296.200A WAC. I <br /> � /i'. //�' I <br /> � Ownerl o zed Agent Signature Date (Revised 9/2014) <br /> I <br />